CORRELATION BETWEEN SERUM MATRIX METALLOPROTEINASE-9 WITH GLOMERULOSCLEROSIS INDEX AND TUBULAR INDEX ATROPHY IN OBSTRUCTIVE KIDNEY STONE PATIENCE AND IMPLEMENTED WITH ESTIMATED GLOMERULAR FILTRATION RATE
By : Tjhin Sun Fu
Faculties : Fakultas Kedokteran
Department : PS. ILMU BEDAH
Glomerulosclerosis and tubular atrophy are usually found on histopathology examination in chronic kidney disease. The aim of this research is to find correlation between serum MMP-9 with glomerulosclerosis and tubular atrophy and implemented with estimated glomerular filtration rate. Sixty two serum of obstructive kidney stone patients were collected during January to December 2013. SEM (Structural Equation Modeling) program Analysis of Moment Structure (AMOS) were used to analyzed relationship and effect of glomerulosclerosis, tubular atrophy and MMP-9 against serum creatinine and eGFR in obstructive kidney stone patients. A cross sectional study in a total of 62 patients with kidney stone consisted 43 (69.3%) males and 19 (30.65%) females, aged (50 ± 10 years) and eGFR 65.41 ± 5.95 ml/min. Histopathology features showed glomerulosclerosis (GS) = 10 (0 – 30) and tubulus normal (TA) = 850 (118 - 1523). Serum creatinine = 1.71 (0.47 – 6.76) and serum MMP-9 = 6.13 (0.05 – 28.37). Direct effects between two construct variables: SC to eGFR = -0.55 (p = 0.001; CR = -6.862) , TA to eLFG = - 0.28 (p = 0.04; CR = 2.030) and GS to eGFR = - 0.16 (p = 0.26, CR = - 1.127). ROC graphics showed serum MMP-9 could diagnose glomerulosklerosis and tubular atrophy (cut off point > 1.82 ng/ml and cut off point > 4.77 ng/ml). Direct effects of serum creatinine and tubular atrophy against eGFR and glomerulosclerosis against eGFR in obstructive kidney stone patients in Sanglah General Hospital Denpasar Bali, respectively were negative 55% and 28% and negative 16%. Indirect effects of MMP-9 against eGFR in obstructed kidney stone was not significant. Serum MMP-9 may be used as a marker of glomerulosclerosis and tubular atrophy in obstructive of kidney stone patients.
Keyword : matrix metalloproteinase-9, glomerulosclerosis, tubular atrophy, eGFR, obstructive kidney stone