Evaluation Value of Serum Total Bilirubin and 25-(OH)D3 in Assessing Treatment Efficacy in Primary Membranous Nephropathy Patients

ZHANG Junhao; WANG Chendan

doi:10.3639/j.issn.2095-3097.2024.11.014

Abstract：Objective To explore the evaluation value of serum total bilirubin(TBIL)and 25-hydroxyvitamin D3[25-(OH)D3]in assessing the treatment efficacy in patients with primary membranous nephropathy(PMN).Methods A total of 155 PMN patients(PMN group)treated in the Department of Nephrology,Shanxi Provincial People's Hospital from January 2021 to June 2023,and 80 healthy volunteers who underwent physical check-ups(control group)were selected.Based on the treat-ment outcomes one year later,the PMN patients were divided into the non-remission group(60 cases)and the remission group(95 cases).Serum TBIL levels were detected using colorimetry,and 25-(OH)D3 levels were detected using enzyme-linked immuno-sorbent assay.Multivariate unconditional logistic regression was used to determine the influencing factors of treatment outcomes,and receiver operating characteristic curves were drawn to analyze the evaluation value of serum TBIL and 25-(OH)D3 lev-els.Results The serum TBIL and 25-(OH)D3 levels in the PMN group were lower than those in the control group(P<0.05).The non-remission rate of treatment in 155 PMN patients was 38.71%(60/155).Independent protective factors for non-remis-sion in PMN patients included high albumin,high estimated glomerular filtration rate,high TBIL,and high 25-(OH)D3,while the independent risk factor was high 24-hour urine protein(P<0.05).The area under the curve for the combined assessment of serum TBIL and 25-(OH)D3 levels for non-remission of treatment in PMN patients was 0.891,higher than that for serum TBIL and 25-(OH)D3 levels alone(0.780 and 0.787,respectively)(P<0.05).Conclusion Decreased serum TBIL and 25-(OH)D3 levels are closely associated with treatment non-remission in PMN patients and may serve as auxiliary indicators for evaluating treatment outcomes.