الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Renal fibrosis is the hallmark and the final common pathway of CKD, regardless of underlying etiology. The pathological finding of renal fibrosis is characterized by progressive tissue scarring including glomerulosclerosis, tubulointerstitial fibrosis, and loss of renal parenchyma (including tubular atrophy, loss of capillaries, and podocytes). Currently, the only clinical tool available to identify fibrosis is a kidney biopsy. However, this approach is invasive and carries certain risks, and is therefore not performed routinely. Identifying biomarkers of fibrosis is indispensible to the understanding of CKD progression since they can offer vital information in a noninvasive manner. Pentraxin-2, is a constitutive, anti-inflammatory plasma protein associated with the innate immune system, has a unique binding profile, suggesting that it may accumulate at injury sites and helps removing damaged tissue in a non-phlogistic manner. Lysyl oxidase plays a key role in promoting fibroblast-to myofibroblast activation in skin, heart, liver, kidney, and lung fibrosis and has been evaluated in many fibrotic conditions, including systemic sclerosis, lung fibrosis, myocardial fibrosis, and hepatic fibrosis. LOX expression was found to be increased in these patients’ serum or relevant tissues. This cross-sectional study aimed to evaluate the predictive value of serum levels of PTX-2 and LOX as markers of renal fibrosis and to compare the results with healthy individuals. This study included 60 patients had an indication for renal biopsy and 30 healthy individuals as a control group for the markers only. Patients were recruited from Nephrology unit, Internal Medicine Department; Tanta University Hospitals during the period from July 2021 to January 2023. Patients were then divided according to pathology result as follows: According to IFTA grades: 1- No to Mild IFTA: 35 patients 2- Moderate to severe IFTA: 25 patients According to Glomerulosclerosis grades: 1-No to mild glomerulosclerosis: 41 patients 2-Moderate to severe glomerulosclerosis: 19 patients All Patients included in the study will be subjected to the following: • Full history taking. • Complete clinical examination • Laboratory investigations including ❖ Complete blood count ❖ Blood urea (mg/dl) ❖ Serum Creatinine (mg/dl) ❖ Serum albumin (g/dl) ❖ Serum Cholesterol & Triglycerides(mg/dl) ❖ Hepatitis C virus antibody ❖ Hepatitis B virus surface antigen ❖ C3 and C4 levels (mg/dl) ❖ ANA & anti-dsDNA 24 hour protein in urine (gm/day) ❖ Serum Uric acid (mg/dl) ❖ The eGFR had been determined using CKD-EPI equation: ❖ Serum PTX-2 level (ng/ml) ❖ Serum LOX level (ng/ml) • Renal biopsy for histopathological examination and fibrosis evaluation. The following results were obtained: • Serum PTX 2 levels decrease significantly while LOX levels increase significantly in patients group than control group. • Lysyl oxidase levels increased with statistically significant results between grades of GS and IFTA while PTX 2 levels were statistically insignificant between those grades. • According to ROC curve, LOX was a good predictor for diagnosis of the degree of IFTA. At a cutoff value of >16.47 sensitivity was 88.0% and specificity was 94.3%. • The Binary logistic regression for LOX in predicting IFTA showed that there was statistically significant relationship between LOX and IFTA that indicate that the degree of IFTA will increase with the increase of the LOX level. • According to ROC curve LOX was a good predictor for diagnosis of the degree of GS. At a cutoff value of >16.47 sensitivity was 89.5% and specificity was 82.9%. • The Binary logistic regression for LOX in predicting GS showed that there was statistically significant relationship between LOX and GS that indicate that the degree of GS will increase with the increase of the LOX level.