Diagnostic value of phosphatidylethanolamine binding protein 4 levels in patients receiving nursing interventions for advanced chronic kidney disease

Abstract

Objective: To explore the diagnostic role of phosphatidylethanolamine binding protein 4 (PEBP4) in patients with chronic kidney disease (CKD) receiving nursing interventions.

Methods: ELISA was used to evaluate serum PEBP4 levels. Receiver-operating characteristic curve analysis was used to assess diagnostic accuracy. Spearman correlation analysis was used to assess the relationships between PEBP4 levels and biochemical indexes.

Results: Serum PEBP4 was high in CKD patients compared with healthy individuals. PEBP4 levels were positively correlated with pathological stage in CKD patients. PEBP4 had higher sensitivity for diagnosis of CKD than common indexes including blood urea nitrogen, creatinine and C-reactive protein. Among CKD patients treated with calcium channel blockers, serum PEBP4 levels declined notably and were associated with concentrations of K⁺, Na⁺, Cl^- and Ca²⁺. Nursing interventions significantly decreased serum PEBP4 levels. A significant association between serum PEBP4 level and ionic concentration was observed in CKD patients receiving nursing interventions.

Conclusions: This prospective study demonstrated that PEBP4 level might represent an effective diagnostic biomarker in CKD patients. PEBP4 also acted as a valuable care compliance factor for determining the necessity for nursing interventions. Nursing interventions restored ion channel function and subsequently resulted in decreased PEBP4 levels and proteinuria.

Keywords: Advanced chronic kidney disease; care compliance; diagnostic biomarker; ion channel; nursing care; phosphatidylethanolamine binding protein 4.

Figure 1.

Association between serum PEBP4 levels and biochemical indexes in CKD patients and healthy controls. (a) Serum PEBP4 levels were measured by ELISA in advanced CKD patients and healthy controls. Correlations between PEBP4 and BUN (b), PEBP4 level and CREA (c), PEBP4 and CysC (d), and PEBP4 and CRP (e) were analyzed using Spearman’s method. The blue circles represent healthy controls and the green circles represent CKD patients. CKD, chronic kidney disease; BUN, blood urea nitrogen; CREA, creatinine; CysC, cystatin C; CRP, C-reactive protein; PEBP4, phosphatidylethanolamine binding protein 4.

Figure 2.

ROC curve analysis of PEBP4 and other CKD biomarkers. (a) Differences in the ROC curves for PEBP4 and CRP. (b) Differences in the ROC curves for PEBP4 and BUN. (c) Differences in the ROC curves for PEBP4 and CREA. The green lines represents the ROC curves for CRP, BUN and CREA, respectively. The blue line represents the ROC curve for PEBP4. The yellow line represents the reference line. AUC, area under the curve; CKD, chronic kidney disease; BUN, blood urea nitrogen; CREA, creatinine; CysC, cystatin C; CRP, C-reactive protein; PEBP4, phosphatidylethanolamine binding protein 4.

Figure 3.

Correlation between serum PEBP4 levels and ion channel function in CKD patients treated with calcium channel blocker. Levels of K⁺ (a), Na⁺ (b), Cl⁻ (c) and Ca²⁺ (d) in healthy controls, CKD patients, and CKD patients treated with calcium channel blockers. (e) Serum PEBP4 levels in healthy controls, CKD patients, and CKD patients receiving calcium channel blockers. Correlations between PEBP4 levels and K⁺ (f), between PEBP4 levels and Na⁺ (g), between PEBP4 levels and Cl⁻ (h) and between PEBP4 levels and Ca²⁺ (i) were analyzed using Spearman’s method. The blue circles represent healthy controls and the green circles represent CKD patients. CKD, chronic kidney disease; PEBP4, phosphatidylethanolamine binding protein 4.

Figure 4.

Effect of care compliance on serum PEBP4 levels in CKD patients. Levels of BUN (a), CREA (b), CysC (c), CRP (d) and serum PEBP4 (e) in healthy controls, CKD patients, and CKD patients receiving nursing interventions. (f) Correlations between PEBP4 levels and care compliance using Spearman analysis in healthy controls, CKD patients, and CKD patients receiving nursing interventions. The green circles represent the intervention group and the blue circles represent the control group. CKD, chronic kidney disease; BUN, blood urea nitrogen; CREA, creatinine; CysC, cystatin C; CRP, C-reactive protein; PEBP4, phosphatidylethanolamine binding protein 4.

Figure 5.

Correlations between serum PEBP4 levels and ion channel function in CKD patients receiving nursing interventions. Levels of K⁺ (a), Na⁺ (b), Cl⁻ (c) and Ca²⁺ (d) in healthy controls, CKD patients, and CKD patients receiving nursing interventions. Correlations between PEBP4 levels and K⁺ (e), between PEBP4 levels and Na⁺ (f), between PEBP4 levels and Cl⁻ (g) and between PEBP4 levels and Ca²⁺ (h) were analyzed using Spearman’s method. The blue circles represent healthy controls and the green circles represent CKD patients. CKD, chronic kidney disease; PEBP4, phosphatidylethanolamine binding protein 4.