Alpha-1-microglobulin as an early biomarker in renal extrahepatic manifestations of hepatitis C virus infection

doi:10.5527/wjn.v15.i2.116866

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Jun 25, 2026; 15(2): 116866
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.116866

Table 1 Demographic and laboratory characteristics of studied populations, mean ± SD (range)/n (%)/median (interquartile range)

Variables	Cases (n = 79)	Controls (n = 79)	P value (F1)¹
Age	49.92 ± 17.23 (20-80)	45.92 ± 16.42 (20-88)	0.140
Gender			0.737
Male	53 (67.1)	51 (64.6)
Female	26 (32.9)	28 (35.4)
Blood picture
White blood cells	5 (2.0-10.0)	5 (2.4-10.0)	0.083
Hemoglobin	12.13 ± 1.77 (8.0-16.0)	12.90 ± 2.01 (6.5-17.0)	0.012
Platelets	191.00 (34-519)	275.00 (68-815)	< 0.001
Kidney functions
Blood urea	4.51 ± 1.43 (2.0-10.0)	4.60 ± 1.21 (2.6-9.0)	0.702
Serum creatinine	72.87 ± 26.48 (30-181)	72.51 ± 17.27 (30-120)	0.919
eGFR	103.92 ± 29.23 (32-175)	101.78 ± 21.80 (55-151)	0.605
Urinary alpha-one-microglobulin	4.11 ± 1.52 (2.11-9.18)	2.54 ± 0.78 (0.77-3.97)	< 0.001
Liver function tests
Total bilirubin	8.00 (3.0-136.0)	7.00 (1.0-19.0)	0.141
Direct bilirubin	5.50 (0.9-96.0)	4.00 (1.0-13.0)	< 0.001
Aspartate aminotransferase	40.00 (12-124)	26.00 (10-87)	< 0.001
Alanine aminotransferase	38.00 (10-130)	26.00 (7-130)	< 0.001
Alkaline phosphatase	67.00 (40-466)	55.00 (38-90)	< 0.001
Albumin	33.90 ± 7.17 (13.0-49.0)	36.87 ± 4.19 (28.0-46.0)	0.002
Coagulation profile
Prothrombin concentration			< 0.001
Normal	54 (70.1)	79 (100.0)
Impaired	23 (29.9)	0 (0.0)
INR			< 0.001
Normal	54 (70.1)	79 (100.0)
Impaired	23 (29.9)	0 (0.0)
Blood glucose			0.999
Normal	78 (98.7)	79 (100.0)
High	1 (1.3)	0 (0.0)
Hemoglobin A1C			0.999
Normal	78 (98.7)	79 (100.0)
Abnormal	1 (1.3)	0 (0.0)

¹F1: Independent t-test quantitative data between two groups. χ² test for qualitative data between the two groups.

eGFR: Estimated glomerular filtration rate; INR: International normalized ratio.

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Table 2 Correlation between Urinary alpha one microglobulin and other variables among studied patients with hepatitis C virus

Variables	Urinary alpha one microglobulin
Variables	r	P value
Age	-0.122	0.291
Kidney functions
Blood urea nitrogen	0.456	< 0.001
Serum creatinine	0.355	0.003
Estimated glomerular filtration rate	-0.267	0.017
Urine albumin/creatinine ratio	0.050	0.659
Liver function tests
Total bilirubin	-0.050	0.664
Direct bilirubin	-0.023	0.843
Aspartate aminotransferase	-0.233	0.039
Alanine aminotransferase	-0.256	0.023
Alkaline phosphatase	-0.113	0.320
Albumin	-0.209	0.065
Polymerase chain reaction value	0.228	0.152
Blood picture
White blood cells	0.146	0.206
Hemoglobin	-0.022	0.847
Platelets	0.071	0.538

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Table 3 Difference in urinary alpha-one-microglobulin according to renal injury among patients with hepatitis C virus, mean ± SD (range)

Variables	Urinary alpha one microglobulin (n = 79)	P value
Hematuria		0.007
Normal	3.76 ± 1.34 (2.11-9.02)
Hematuria	4.71 ± 1.67 (2.50-9.18)
Proteinuria		0.311
Normal	3.67 ± 1.06 (2.34-5.33)
Proteinuria	4.18 ± 1.59 (2.11-9.18)
Estimated glomerular filtration rate		< 0.001
< 60 (impaired)	6.35 ± 2.54 (2.74-9.18)
≥ 60	3.89 ± 1.22 (2.11-7.00)
Renal injury		0.235
Yes	4.17 ± 1.56(2.11-9.18)
No	3.45 ± 1.01 (2.34-5.00)

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Table 4 Characteristics of hepatitis c virus-positive patients groups based on presence or absence of a renal biopsy, mean ± SD (range)/n (%)/median (interquartile range)

Variables	Patients with renal biopsy (n = 5)	Patients without renal biopsy (n = 74)
Age	38.80 ± 14.85 (26-59)	50.80 ± 16.987 (20-80)
Sex
Male	2 (40.0)	23 (31.1)
Female	3 (60.0)	51 (68.9)
Kidney functions
Blood urea nitrogen	7.60 ± 2.51 (4.0-10.0)	4.3 ± 1.7 (2-10)
Serum creatinine	125.80 ± 42.72 (67-181)	75.8 ± 26.9 (43-146)
Estimated glomerular filtration rate (mL/minute/1.73 m²)	58.20 ± 26.65 (32-100)	106.32 ± 27.017 (44-175)
< 60 (impaired)	3 (60.0)	4 (5.4)
≥ 60	2 (40.0)	70 (94.6)
Urine albumin-to-creatinine ratio	2300.00 (1500.0-3500.0)	553.23 (13.40-1131.8)
Macroalbuminuria	5 (100.0)	34 (45.9)
Hematuria	5 (100.0)	39 (52.7)
C3/C4
Normal	2 (40.0)	68 (91.9)
Abnormal	3 (60.0)	6 (8.1)
PCR for HCV
Detectable	0 (0)	41 (55.4)
Below detection limit	5 (100.0)	33 (44.6)
Uα1M	6.12 ± 2.36 (4.33-9.187)	3.976 ± 1.383 (2.116-9.022)

C3: Complement 3; C4: Complement 4; PCR: Polymerase chain reaction; HCV: Hepatitis C virus; Uα1M: Urinary alpha-one microglobulin.

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Table 5 Diagnostic ability of Urinary alpha-one-microglobulin to differentiate between patients with hepatitis C virus and controls

Indices	Urinary alpha-one-microglobulin
AUC (95%CI)	0.864 (0.801-0.913)
Optimal cut off	> 3.52 mg/L
Accuracy	77.0%
Sensitivity	60.0%
Specificity	93.7%
Positive predictive value	90.4%
Negative predictive value	69.8%
P value	< 0.001

AUC: Area under the curve; CI: Confidence interval.

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Citation: Alkareemy EAR, Azoz NM, Abdelnaiem GS, Gadelkareem RA, Saleh KA, Abdel Aziz EM. Alpha-1-microglobulin as an early biomarker in renal extrahepatic manifestations of hepatitis C virus infection. World J Nephrol 2026; 15(2): 116866
URL: https://www.wjgnet.com/2220-6124/full/v15/i2/116866.htm
DOI: https://dx.doi.org/10.5527/wjn.v15.i2.116866

Alkareemy EAR, Azoz NM, Abdelnaiem GS, Gadelkareem RA, Saleh KA, Abdel Aziz EM. Alpha-1-microglobulin as an early biomarker in renal extrahepatic manifestations of hepatitis C virus infection. World J Nephrol 2026; 15(2): 116866 [DOI: 10.5527/wjn.v15.i2.116866]

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