Changes of plasma sonic hedgehog and its clinical significance in chronic kidney disease stage 3-5

Objective To examine the changes of plasma levels of sonic hedgehog(SHH) in patients with chronic kidney disease(CKD) stage 3-5 and explore the clinical characteristics.Methods Plasma levels of SHH from 20 normal healthy people and 64 patients with CKD stage 3-5 were measured by enzyme-linked immune sorbent assay. And the changes of plasma level of SHH were examined. According to estimated glomerular filtration rate(eGFR),they were divided into different stages. The correlations were determined between SHH level and serum creatinine,blood urea nitrogen(BUN),eGFR and left ventricular mass index(LVMI). Subsequently the changes of plasma levels of SHH were tested between left ventricular hypertrophy and non-left ventricular hypertrophy patients. Finally multi-factor analysis of left ventricular hypertrophy was performed.Results The plasma concentration of SHH was significantly higher in CKD group than that in control group. The plasma level of SHH gradually increased with a lowering of eGFR. Obviously higher in stage 4/5 than that in stage 3,it was correlated negatively with eGFR and positively with serum creatinine and BUN. Plasma SHH in left ventricular hypertrophy patients was dramatically higher that in non-left ventricular hypertrophy group. The plasma level of SHH was positively correlated with LVMI and acted as an independent risk factor for left ventricular hypertrophy in CKD patients.Conclusions Playing an important role in the pathogenesis of CKD,SHH may be employed for gauging the degree of renal damage and judging the extent of left ventricular hypertrophy in CKD patients.