The Diagnostic Value of Tumor Necrosis Factor α Receptor 2 as a Marker of Renal Dysfunction

Abstract

Background: Chronic kidney disease (CKD) is increasingly recognized as global health problem. There is evidence that CKD can be detected using simple laboratory tests, and that treatment can prevent or delay complications of decreased kidney function, slow the progression of kidney disease and reduce the risk of cardiovascular disease (CVD). 
Aim: The present study was conducted to evaluate the role of tumor necrosis factor α  receptor 2 (TNFR2) as a biomarker for detection of renal dysfunction. 
Materials and Methods: The study was carried out for the period from February to June 2019 and included 180 patients (their ages were between 19 and 85 years old) and were divided into 60 patients with renal impairment, 60 hemodialysis patients, and 60 patients with normal renal function (as a control group). Each group included patients with hypertension, patients with diabetes mellitus, and hypertensive- diabetic patients.  The patients were attended to Center of Kidney Disease and Transplantation,  Dialysis Unit of  Baghdad  Teaching Hospital – Medical City , Dialysis Unit of  Tikrit Teaching Hospital and private laboratory in Samarra City. 
Urine sample was collected from each patient for bacteriological study and detection the level of TNFR2. 
Results: The present study revealed that only 18% of samples had positive bacterial growth. The most common isolated bacteria were E.coli. The mean of TNFR2 was higher in patients with renal impairment and positive urine culture than those with negative culture. However, the difference was statistically significant. The difference in the mean of TNFR2 between hemodialysis patients with positive urine culture and those with negative culture was statistically non- significant. The mean of TNFR2 in the patients with positive urine culture was higher than those with negative culture. The  difference was statistically non- significant. The  difference in the mean of TNFR2  between  hypertensive  patients  with  normal  renal  function  (control)  and hypertensive- hemodialysis was statistically significant. 
Conclusion: Level of urine TNFR2 can be used as a marker for early detection of renal dysfunction.