The Levels and Significance of Serum Sex Hormones, BMP-7, and RBP in Adult Male Patients With Primary Nephrotic...

There remain significant challenges in assessing the risk of primary nephrotic syndrome (PNS) and concomitant acute kidney injury (AKI) in adult males. AKI is characterized by decreased glomerular filtration rate. This study investigates the levels of serum sex hormones, bone morphogenetic protein-7 (BMP-7), and retinol-binding protein (RBP) and their significance in adult male patients with PNS and concomitant AKI.

This retrospective analysis enrolled 86 adult male PNS patients admitted to Wuxi No.2 People's Hospital between January 2020 and November 2023 as the PNS group, and 80 healthy adult males as the healthy group. Serum levels of sex hormones-estradiol (E2), testosterone (T), follicle-stimulating hormone (FSH), and luteinizing hormone (LH)-as well as bone morphogenetic protein-7 (BMP-7) and RBP were compared between the two groups. Furthermore, PNS patients were stratified into PNS groups with or without AKI cohorts based on glomerular filtration rate. Additionally, the levels of these parameters were compared between the subgroups.

In the PNS group, the levels of E2 and RBP were 66.67 ± 18.87 pg/mL and 56.65 ± 17.23 mg/L, respectively, both significantly higher than those in the healthy group (p < 0.05). Conversely, FSH and BMP-7 levels were 3.84 ± 1.02 IU/L and 1.83 ± 0.44 ng/mL, respectively, both significantly lower than those in the healthy group (p < 0.05). Within the PNS group, patients with AKI demonstrated significantly higher E2 levels of 69.93 ± 9.95 pg/mL than non-AKI patients (p < 0.05). FSH and BMP-7 levels were substantially lower (3.45 ± 0.96 IU/L and 1.57 ± 0.35 ng/mL) than in non-AKI patients (p < 0.05). However, RBP level was considerably higher (62.23 ± 12.01 mg/L) in those with AKI (p < 0.05). Furthermore, serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (Cys C) levels were 167.23 ± 34.43 μmol/L, 11.14 ± 2.23 mmol/L, and 2.02 ± 0.72 mg/L, respectively, all significantly higher in patients with AKI than in non-AKI (p < 0.05). Regression analysis identified E2, BMP-7, and RBP as independent predictors for assessing AKI risk in PNS patients, with corresponding odds ratios (ORs) (95% confidence interval (CI)) values of 1.092 (1.016-1.175), 0.021 (0.002-0.184), and 1.095 (1.032-1.162), respectively (p < 0.05).

Male patients with PNS exhibit abnormal serum sex hormone, BMP-7, and RBP levels, which are associated with AKI. E2, BMP-7, and RBP levels demonstrate significant predictive potential in assessing AKI risk in PNS.