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Dhama K, Latheef SK, Dadar M, Samad HA, Munjal A, Khandia R, Karthik K, Tiwari R, Yatoo MI, Bhatt P, Chakraborty S, Singh KP, Iqbal HMN, Chaicumpa W, Joshi SK. Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values. Front Mol Biosci 2019. [PMID: 31750312 DOI: 10.3389/fmolb.2019.0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Shyma K Latheef
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Maryam Dadar
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization, Karaj, Iran
| | - Hari Abdul Samad
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Ashok Munjal
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Rekha Khandia
- Department of Genetics, Barkatullah University, Bhopal, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan, Mathura, India
| | - Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Srinagar, India
| | - Prakash Bhatt
- Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, Agartala, India
| | - Karam Pal Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Hafiz M N Iqbal
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, Mexico
| | - Wanpen Chaicumpa
- Department of Parasitology, Faculty of Medicine, Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sunil Kumar Joshi
- Division of Hematology, Oncology and Bone Marrow Transplantation, Department of Microbiology & Immunology, Department of Pediatrics, University of Miami School of Medicine, Miami, FL, United States
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102
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Satirapoj B, Pooluea P, Nata N, Supasyndh O. Urinary biomarkers of tubular injury to predict renal progression and end stage renal disease in type 2 diabetes mellitus with advanced nephropathy: A prospective cohort study. J Diabetes Complications 2019; 33:675-681. [PMID: 31227289 DOI: 10.1016/j.jdiacomp.2019.05.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Novel potential tubular biomarkers in diabetic nephropathy could improve risk stratification and prediction. The study aimed to evaluate the association of tubular damage markers with rapid renal progression and incidence of end stage renal disease (ESRD) in type 2 diabetes (T2DM). METHODS A prospective cohort study, involving a total of 257 patients with T2DM, was included. The baseline values of urine albumin, cystatin-C, angiotensinogen, kidney injury molecule-1 (KIM-1) and neutrophil-gelatinase associated lipocalin (NGAL) were measured. The composite outcomes included a rapid glomerular filtration rate (GFR) decline or incident of ESRD at 3-year follow-up. MAIN FINDINGS The composite outcomes were noted in 26.1%. Using univariate followed by multivariate COX proportional hazard regression analysis, the patients with highest quartiles of urine cystatin-C (HR 2.96, 95% CI, 1.38-6.35), urine angiotensinogen (HR 2.93, 95% CI, 1.40- 6.13) urine KIM-1 (HR 2.77, 95% CI, 1.27-6.05) and urine NGAL (HR 2.53, 95% CI, 1.11-5.76) were significantly associated with rapid renal progression when compared with the patients with the lowest quartiles of all tubular biomarkers. CONCLUSIONS Patients with T2DM with high levels of baseline urine tubular biomarkers (cystatin-C, angiotensinogen, KIM-1 and NGAL) had a greater incidence of ESRD and rapid GFR decline.
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Affiliation(s)
- Bancha Satirapoj
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
| | - Pimanong Pooluea
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Naowanit Nata
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Ouppatham Supasyndh
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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103
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Urine and plasma concentrations of amino acids and plasma vitamin status differ, and are differently affected by salmon intake, in obese Zucker fa/fa rats with impaired kidney function and in Long-Evans rats with healthy kidneys. Br J Nutr 2019; 122:262-273. [DOI: 10.1017/s0007114519001284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractKidney function affects amino acid metabolism and vitamin status. The aims of the present study were to investigate urine and plasma concentrations of amino acids as well as plasma vitamin status in rats with impaired renal function (Zucker fa/fa rats) and in rats with normal kidney function (Long-Evans rats), and to explore the effects of salmon intake on these parameters and potential biomarkers of salmon intake in both rat strains. Male rats were fed diets with casein as sole protein source (control diet) or 25 % protein from baked salmon and 75 % casein for 4 weeks. Urine concentrations of markers of renal function and most amino acids and plasma concentrations of most vitamins were higher, and plasma concentrations of several amino acids including arginine, total glutathione and most tryptophan metabolites were lower in Zucker fa/fa rats compared with Long-Evans rats fed the control diet. Concentrations of kidney function markers were lower after salmon intake only in Zucker fa/fa rats. A trend towards lower urine concentrations of amino acids was seen in both rat strains fed the salmon diet, but this was more pronounced in Long-Evans rats and did not reflect the dietary amino acid content. Urine 1-methylhistidine, 3-methylhistidine, trimethylamineoxide and creatine concentrations, and plasma 1-methylhistidine and creatine concentrations were higher after salmon intake in both rat strains. To conclude, concentrations of amino acids in urine and plasma as well as vitamin status were different in Zucker fa/fa and Long-Evans rats, and the effects of salmon intake differed by rat strain for some of these parameters.
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104
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Diagnostic role of kidney injury molecule-1 in renal cell carcinoma. Int Urol Nephrol 2019; 51:1893-1902. [DOI: 10.1007/s11255-019-02231-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
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105
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Charrin E, Faes C, Sotiaux A, Skinner S, Pialoux V, Joly P, Connes P, Martin C. Receptor for Advanced Glycation End Products Antagonism Blunts Kidney Damage in Transgenic Townes Sickle Mice. Front Physiol 2019; 10:880. [PMID: 31396093 PMCID: PMC6663971 DOI: 10.3389/fphys.2019.00880] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 06/24/2019] [Indexed: 01/04/2023] Open
Abstract
A large proportion of adult patients with sickle cell disease (SCD) develops kidney disease and is at a high risk of mortality. The contribution of advanced glycation end products and their receptor (AGE/RAGE) axis has been established in the pathogenesis of multiple kidney diseases. The aim of the present study was to determine the implication of RAGE in the development of SCD-related kidney complications in a mouse model of SCD, as this has never been investigated. 8-week-old AA (normal) and SS (homozygous SCD) Townes mice were treated with a specific RAGE antagonist (RAP) or vehicle (NaCl). After 3 weeks of treatment, red blood cell count, hematocrit, and hemoglobin levels were significantly higher in RAP-treated SS mice. Reticulocyte count and sickle cell count were reduced in RAP-SS compared to their NaCl-treated littermates. The lower NADPH oxidase activity in the kidney of RAP-treated mice compared to NaCl-treated mice suggests limited ROS production. RAP-treated SS mice had decreased NF-κB protein expression and activation as well as reduced TNF-α mRNA expression in the kidney. Glomerular area, interstitial fibrosis, tubular iron deposits, and KIM-1 protein expression were significantly reduced after RAP treatment. In conclusion, this study provides evidence supporting the pathogenic role of RAGE in kidney injuries in sickle cell mice.
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Affiliation(s)
- Emmanuelle Charrin
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Camille Faes
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Amandine Sotiaux
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Sarah Skinner
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France
| | - Vincent Pialoux
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Institut Universitaire de France, Paris, France
| | - Philippe Joly
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Groupement Hospitalier Est, UF "Biochimie des Pathologies érythrocytaires" Centre de Biologie Est, CHU de Lyon, Lyon, France
| | - Philippe Connes
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France.,Institut Universitaire de France, Paris, France
| | - Cyril Martin
- Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Lyon, France.,Laboratory of Excellence "GR-Ex", Paris, France
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106
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Keshavarz Shahbaz S, Pourrezagholi F, Nafar M, Ahmadpoor P, Barabadi M, Foroughi F, Hosseinzadeh M, Yekaninejad MS, Amirzargar A. Dynamic variation of kidney injury molecule-1 mRNA and protein expression in blood and urine of renal transplant recipients: a cohort study. Clin Exp Nephrol 2019; 23:1235-1249. [PMID: 31302846 DOI: 10.1007/s10157-019-01765-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/14/2019] [Indexed: 01/10/2023]
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107
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Khan FA, Fatima SS, Khan GM, Shahid S. Evaluation of kidney injury molecule-1 as a disease progression biomarker in diabetic nephropathy. Pak J Med Sci 2019; 35:992-996. [PMID: 31372130 PMCID: PMC6659046 DOI: 10.12669/pjms.35.4.154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background & Objective: Kidney Injury Molecule-1 (KIM-1) is a peptide whose release into circulation is specific to tubular injury. This study aimed to estimate levels of kidney injury molecule-1 in diabetic patients with and without kidney disease. And evaluate the role of KIM-1 as an early screening marker of progressive kidney injury. Methods: This follow-up study included n=85 subjects from the diabetic clinic of Jinnah Post Graduate Medical Center (JPMC) in collaboration with Aga Khan University from November 2016 till September 2017. They were divided as: i) Group A1 (n=30) participants with diabetes for <5 years without microalbuminuria ii) Group A2 (n= 30) subjects with diabetes for 6-10 years with microalbuminuria; iii) Group B (n=25) subjects as healthy control group. All study participants were followed for 6 months and their blood glucose, urea, creatinine, electrolytes, albuminuria and serum KIM-1 were assayed. Results: High KIM-1 at baseline was present in group A2 patients as compared to controls and group A1 (p<0.001). Higher levels were seen after six months in group A1 along with the presence of micro albuminuria (p<0.001) suggesting kidney damage. Moderate positive association were seen for KIM1 with creatinine levels (r=0.530; p<0.001), and HbA1c (r=0.576; p<0.001) in all patients. While a strong positive association was seen for blood urea nitrogen as a marker for kidney function both at baseline (r= 0.728; p=0.000) and follow up (r=0.747; p=0.001). Multiple logistic regression controlling for age showed that KIM1 was independently associated with BUN (r=0.727; p<0.001), creatinine (r=0.510; p<0.001) and HbA1c (r=0.401; p=0.008) in all groups. Conclusion: Rising KIM-1 levels with progressive kidney damage with or without derangement of kidney function is reported in this study. This finding may pave a way towards identifying KIM1 as a prognostic marker for kidney injury.
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Affiliation(s)
- Fatima Abid Khan
- Fatima Abid Khan, Department of Physiology, Jinnah Sindh Medical University, Karachi Pakistan
| | - Syeda Sadia Fatima
- Syeda Sadia Fatima, Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Ghulam Mustafa Khan
- Ghulam Mustafa Khan, Department of Physiology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
| | - Sana Shahid
- Sana Shahid, Department of Physiology, Sir Syed College of Medicine for Girls, Karachi, Pakistan
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108
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Siddiqui K, Joy SS, Al-Rubeaan K. Association of urinary monocyte chemoattractant protein-1 (MCP-1) and kidney injury molecule-1 (KIM-1) with risk factors of diabetic kidney disease in type 2 diabetes patients. Int Urol Nephrol 2019; 51:1379-1386. [PMID: 31250339 DOI: 10.1007/s11255-019-02201-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 06/10/2019] [Indexed: 01/10/2023]
Abstract
PURPOSE Urinary kidney injury molecule-1 and monocyte chemoattractant protein-1 are significance factors in the diagnosis and intervention of diabetic kidney diseases. This study determined levels of these proteins in diabetic patients with varying degrees of kidney disease and assessed their relationship with risk factors associated with diabetic kidney diseases. METHODS A total of 185 patients with type 2 diabetes were divided into three groups [low risk (n = 47), moderate risk (n = 63), and high risk (n = 75)] based on the severity of diabetic kidney disease according to kidney disease: improving global outcomes guidelines. Both urinary kidney injury molecule-1 and monocyte chemoattractant protein-1 levels were measured by enzyme-linked immunosorbent assay. Student`s t test, analysis of variance, and Spearman's correlation were used for statistical analysis. RESULTS The kidney injury molecule-1-to-creatinine ratio (P = 0.035) and monocyte chemoattractant protein-1-to-creatinine ratio (P < 0.001) increased significantly with the increase in kidney disease severity and varied according to different albuminuria statuses and estimated glomerular-filtration rates. The monocyte chemoattractant protein-1-to-creatinine ratio showed a significant correlation with hemoglobin A1c (P = 0.002) and inflammatory marker levels (interleukin-6, P = 0.005; tumor necrosis factor-α, P < 0.001). CONCLUSION Urinary levels of both kidney injury molecule-1 and monocyte chemoattractant protein-1 represent distinguishing markers for the evaluation of diabetic kidney disease progression according to the associated degrees of albuminuria or/and the estimated glomerular-filtration rate. In addition, correlations between urinary monocyte chemoattractant protein-1 and glycemic and inflammatory marker levels revealed the role of hyperglycemia and chronic inflammation in the pathogenesis of diabetic kidney disease.
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Affiliation(s)
- Khalid Siddiqui
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Salini Scaria Joy
- Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Al-Rubeaan
- University Diabetes Center, King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia
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109
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Lipcsey M, Hanslin K, Stålberg J, Smekal D, Larsson A. The time course of calprotectin liberation from human neutrophil granulocytes after Escherichia coli and endotoxin challenge. Innate Immun 2019; 25:369-373. [PMID: 31109223 PMCID: PMC7103615 DOI: 10.1177/1753425919848476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Plasma calprotectin has previously been reported as a biomarker for sepsis. The aim of the present study was to elucidate the kinetics of calprotectin release from neutrophils exposed to Escherichia coli and endotoxin. Whole blood samples were exposed to E. coli bacteria or endotoxin in vitro. Blood samples were collected after 0, 1, 2, 3 and 4 h and plasma calprotectin was analysed by particle enhanced turbidimetric immunoassay while TNF-α, IL-6, neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were analyzed by ELISA. When neutrophils were exposed to either E. coli or endotoxin, calprotectin levels began to increase within a couple of hours after the challenge. Calprotectin increases early in response to bacterial challenge. Given the logistic advantages of the calprotectin analysis, this may be of interest for early diagnosis of bacterial infections.
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Affiliation(s)
- Miklos Lipcsey
- 1 CIRRUS, Department of Surgical Sciences/Anaesthesiology and Intensive Care Medicine, Uppsala University, Sweden.,2 Hedenstierna laboratory, Department of Surgical Sciences/Anaesthesiology and Intensive Care Medicine, Uppsala University, Sweden
| | - Katja Hanslin
- 3 Department of Medical Sciences/Infectious diseases, Uppsala University, Sweden
| | - Johan Stålberg
- 4 Department of Medical Sciences/Clinical chemistry, Uppsala University, Sweden
| | - David Smekal
- 1 CIRRUS, Department of Surgical Sciences/Anaesthesiology and Intensive Care Medicine, Uppsala University, Sweden
| | - Anders Larsson
- 4 Department of Medical Sciences/Clinical chemistry, Uppsala University, Sweden
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110
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Maass C, Sorensen NB, Himmelfarb J, Kelly EJ, Stokes CL, Cirit M. Translational Assessment of Drug-Induced Proximal Tubule Injury Using a Kidney Microphysiological System. CPT Pharmacometrics Syst Pharmacol 2019; 8:316-325. [PMID: 30869201 PMCID: PMC6539699 DOI: 10.1002/psp4.12400] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/28/2019] [Indexed: 01/04/2023] Open
Abstract
Drug-induced kidney injury, a major cause of acute kidney injury, results in progressive kidney disease and is linked to increased mortality in hospitalized patients. Primary injury sites of drug-induced kidney injury are proximal tubules. Clinically, kidney injury molecule-1, an established tubule-specific biomarker, is monitored to assess the presence and progression of injury. The ability to accurately predict drug-related nephrotoxicity preclinically would reduce patient burden and drug attrition rates, yet state-of-the-art in vitro and animal models fail to do so. In this study, we demonstrate the use of kidney injury molecule-1 measurement in the kidney microphysiological system as a preclinical model for drug toxicity assessment. To show clinical relevance, we use quantitative systems pharmacology computational models for in vitro-in vivo translation of the experimental results and to identify favorable dosing regimens for one of the tested drugs.
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Affiliation(s)
- Christian Maass
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Nathan B. Sorensen
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
| | - Jonathan Himmelfarb
- Department of MedicineKidney Research InstituteUniversity of WashingtonSeattleWashingtonUSA
| | - Edward J. Kelly
- Department of PharmaceuticsUniversity of WashingtonSeattleWashingtonUSA
| | | | - Murat Cirit
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMassachusettsUSA
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111
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Cai J, Jiao X, Luo W, Chen J, Xu X, Fang Y, Ding X, Yu X. Kidney injury molecule-1 expression predicts structural damage and outcome in histological acute tubular injury. Ren Fail 2019; 41:80-87. [PMID: 30909833 PMCID: PMC6442099 DOI: 10.1080/0886022x.2019.1578234] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: A few studies have shown that urinary kidney injury molecule-1 (uKIM-1) levels are increased in acute kidney injury (AKI); however, the correlation between uKIM-1 and histological tubular injury, which is considered to be the gold standard for evaluating renal damage and predicting prognosis, is still unclear. We performed this study to determine whether the predicted value of uKIM-1 is correlated with renal KIM-1 (tKIM-1) expression and tissue damage in AKI patients. Methods: This retrospective study recruited 14 healthy individuals and 27 biopsy-proven acute tubular injury (ATI) patients. uKIM-1 and plasma KIM-1 (sKIM-1) levels were measured by ELISA, and tKIM-1 expression was evaluated by immunohistochemistry. Results: Elevated levels of urinary, plasma, and renal KIM-1 were found in ATI patients. The uKIM-1 concentration was positively correlated with tKIM-1 expression and reflected the severity of renal histological injury. The outcome of ATI was associated with uKIM-1 expression: the ATI patients with higher uKIM-1 levels had an increased potential for an incomplete recovery of renal function during follow-up. Additionally, the level of KIM-1, regardless of source, was negatively related to the eGFR, and ROC curve analysis revealed that the ROC-AUC was 0.923 (p = 0.000) for the diagnosis of ATI based on a combination of high uKIM-1 and sKIM-1 levels. Conclusion: The uKIM-1 level corresponds with the severity of renal histological damage and can be a potential reliable predictor of adverse renal outcomes in ATI patients. Moreover, combining uKIM-1 and sKIM-1 can increase the sensitivity and specificity of the diagnosis of severe ATI.
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Affiliation(s)
- Jieru Cai
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China
| | - Xiaoyan Jiao
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China
| | - Weili Luo
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China
| | - Jing Chen
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China
| | - Xunhui Xu
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China
| | - Yi Fang
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China.,d Shanghai Institute of Kidney and Dialysis , Shanghai , China
| | - Xiaoqiang Ding
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China.,d Shanghai Institute of Kidney and Dialysis , Shanghai , China
| | - Xiaofang Yu
- a Department of Nephrology , Zhongshan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.,b Shanghai Key Laboratory of Kidney and Blood Purification , Shanghai , China.,c Shanghai Medical Center for Kidney , Shanghai , China.,d Shanghai Institute of Kidney and Dialysis , Shanghai , China
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112
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Díaz de León-Martínez L, Díaz-Barriga F, Barbier O, Ortíz DLG, Ortega-Romero M, Pérez-Vázquez F, Flores-Ramírez R. Evaluation of emerging biomarkers of renal damage and exposure to aflatoxin-B 1 in Mexican indigenous women: a pilot study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:12205-12216. [PMID: 30835068 DOI: 10.1007/s11356-019-04634-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 02/19/2019] [Indexed: 05/18/2023]
Abstract
Aflatoxins (AFs) are mycotoxins produced by Aspergillus parasiticus and Aspergillus flavus which frequently contaminate maize. These compounds are considered toxic, especially AFB1 which has been classified as a human carcinogen, due to its relationship with the generation of hepatocellular carcinoma. Studies in vivo, in animal models, prove that chronic consumption of AFB1 has an association with renal adverse effects, but evidence in humans is scarce. Therefore, the main objective of this research was to conduct a pilot study to evaluate the correlation between exposure to AFB1 and early-stage renal damage in indigenous women of San Luis Potosí, Mexico. Exposure to AFB1 was measured through the biomarker AFB1-lysine and renal damage through kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and cystatin-C (Cys-C). AFB1-Lys was measured by HPLC-FLD. The method was validated with a correlation coefficient of 0.99 and limit of detection and quantification of 3.5 and 4.7 pg mL-1, respectively. Levels of NGAL, KIM-1, and Cys-C were determined (median (P25-P75), 5.96 (3.16-15.91), 0.137 (0.137-0.281), and 18.49 (5.76-29.57) ng mL-1, respectively). Additionally, glomerular filtration rate (GFR) (83.3 (59.8-107.4) mL/min/1.73 m2) and serum creatinine (SCr) (0.88 (0.72-1.22) mg dL-1) were obtained. The median concentrations for AFB1-Lys were 2.08 (1.89-5.8) pg mg-1 of albumin. Statistically significant correlations between AFB1-Lys/KIM-1 (Rho = 0.498, p = 0.007) and AFB1/Cys-C (Rho = 0.431, p = 0.014) were found. Our results indicate that women are exposed to AFB1, due to the fact that the AFB1-Lys biomarker was found in a high percentage of the study population (83%). In addition, the results of exposure to AFB1 show a strong significant correlation between KIM-1 and Cys-C that may indicate the toxic renal effect. These results are alarming because of the high toxicity of this compound and require adequate intervention to reduce AFB1 exposure in these populations.
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Affiliation(s)
- Lorena Díaz de León-Martínez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Fernando Díaz-Barriga
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Olivier Barbier
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City, Mexico
| | - Dora Linda Guzmán Ortíz
- Departamento de Biotecnología y Bioquímica Centro de Investigación de Estudios Avanzados del -Instituto Politécnico Nacional (CINVESTAV-IPN), Campus Guanajuato, Irapuato, Mexico
| | - Manolo Ortega-Romero
- Departamento de Toxicología, Centro de Investigación y de Estudios Avanzados-Instituto Politécnico Nacional (CINVESTAV-IPN), Mexico City, Mexico
| | - Francisco Pérez-Vázquez
- Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico
| | - Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Avenida Sierra Leona No. 550, Colonia Lomas Segunda Sección, 78210, San Luis Potosí, SLP, Mexico.
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Guo J, Song W, Boulanger J, Xu EY, Wang F, Zhang Y, He Q, Wang S, Yang L, Pryce C, Phillips L, MacKenna D, Leberer E, Ibraghimov-Beskrovnaya O, Ding J, Liu S. Dysregulated Expression of microRNA-21 and Disease-Related Genes in Human Patients and in a Mouse Model of Alport Syndrome. Hum Gene Ther 2019; 30:865-881. [PMID: 30808234 DOI: 10.1089/hum.2018.205] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Alport syndrome is a genetic disease caused by mutations in type IV collagen and is characterized by progressive kidney disease. The Col4α3-/- mouse model recapitulates the main features of human Alport syndrome. Previously, it was reported that kidney microRNA-21 (miR-21) expression is significantly increased in Col4α3-/- mice, and administration of anti-miR-21 oligonucleotides (anti-miR-21) attenuates kidney disease progression in Col4α3-/- mice, indicating that miR-21 is a viable therapeutic target for Alport syndrome. However, the expression pattern of miR-21 in the kidneys of patients with human Alport syndrome has not been evaluated. Paraffin-embedded kidney specimens were obtained from 27 patients with Alport syndrome and from 10 normal controls. They were evaluated for miR-21 expression and for in situ hybridization and mRNA expression by quantitative polymerase chain reaction. In addition, anti-miR-21 was administrated to Col4α3-/- mice at different stages of disease, and changes in proteinuria, kidney function, and survival were monitored. Transcriptomic analysis of mouse kidney was conducted using RNA sequencing. miR-21 expression was significantly elevated in kidney specimens from patients with Alport syndrome compared to normal controls. Elevated renal miR-21 expression positively correlated with 24 h urine protein, serum blood urea nitrogen, serum creatinine, and severity of kidney pathology. On histological evaluation, high levels of miR-21 were localized to damaged tubular epithelial cells and glomeruli. Kidney specimens from both humans and mice with Alport syndrome exhibited abnormal expression of genes involved in kidney injury, fibrosis, inflammation, mitochondrial function, and lipid metabolism. Administration of anti-miR-21 to Alport mice resulted in slowing of kidney function decline, partial reversal of abnormal gene expression associated with disease pathology, and improved survival. Increased levels of miR-21 in human Alport kidney samples showed a correlation with kidney disease severity measured by proteinuria, biomarkers of kidney function, and kidney histopathology scores. These human data, combined with the finding that a reduction of miR-21 in Col4α3-/- mice improves kidney phenotype and survival, support miR-21 as a viable therapeutic target for the treatment of Alport syndrome.
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Affiliation(s)
- Jifan Guo
- 1Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Wenping Song
- 2Rare Disease Research, Sanofi Genzyme, Framingham, Massachusetts
| | - Joseph Boulanger
- 2Rare Disease Research, Sanofi Genzyme, Framingham, Massachusetts
| | - Ethan Y Xu
- 3Translational Sciences, Sanofi Genzyme, Framingham, Massachusetts
| | - Fang Wang
- 1Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Yanqin Zhang
- 1Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Qun He
- 4Department of Urology, Peking University First Hospital, Beijing, P.R. China
| | - Suxia Wang
- 5Laboratory of Electron Microscopy, Peking University First Hospital, Beijing, P.R. China
| | - Li Yang
- 6Department of Internal Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, P.R. China
| | - Cynthia Pryce
- 2Rare Disease Research, Sanofi Genzyme, Framingham, Massachusetts
| | - Lucy Phillips
- 2Rare Disease Research, Sanofi Genzyme, Framingham, Massachusetts
| | | | | | | | - Jie Ding
- 1Department of Pediatrics, Peking University First Hospital, Beijing, P.R. China
| | - Shiguang Liu
- 2Rare Disease Research, Sanofi Genzyme, Framingham, Massachusetts
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114
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Increased Intra-abdominal Pressure Induces Acute Kidney Injury in an Experimental Model of Congestive Heart Failure. J Card Fail 2019; 25:468-478. [PMID: 30880249 DOI: 10.1016/j.cardfail.2019.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 03/07/2019] [Accepted: 03/11/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Congestive heart failure (CHF) entails a complex interaction between the heart and the kidney that represents a clinical entity called cardiorenal syndrome (CRS). One of the mechanisms underlying CRS includes increased intra-abdominal pressure (IAP). We examined the effect of elevated IAP on kidney function in rats with low- and high-output CHF. METHODS AND RESULTS Rats with compensated and decompensated CHF induced by means of aortocaval fistula, rats with myocardial infraction (MI) induced by means of left anterior descending artery ligation, and sham control rats were subjected to either 10 or 14 mm Hg IAP. Urine flow (V), Na+ excretion (UNaV), glomerular filtration rate (GFR), and renal plasma flow (RPF) were determined. The effects of pretreatment with tadalafil (10 mg/kg orally for 4 days) on the adverse renal effects of IAP were examined in decompensated CHF and MI. Basal V and GFR were significantly lower in rats with decompensated CHF compared with sham control rats. Decompensated CHF rats and MI rats subjected to 10 and 14 mm Hg IAP exhibited more significant declines in V, UNaV, GFR and RPF than compensated and sham controls. Elevated IAP also induced tubular injury, as evidenced by significantly increased absolute urinary excretion of neutrophil gelatinase-associated lipocalin. In addition, in a nonquantitative histologic analysis, elevated IAP was associated with increase in necrosis and cell shedding to the tubule lumens, especially in the decompensated CHF subgroup. Pretreatment of decompensated CHF rats and MI rats with tadalafil ameliorated the adverse renal effects of high IAP. CONCLUSIONS Elevated IAP contributes to kidney dysfunction in high- and low-cardiac output CHF. IAP induces both hemodynamic alterations and renal tubular dysfunction. These deleterious effects are potentially reversible and can be ameliorated with the use of phosphodiesterase-5 inhibition.
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115
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Wewers TM, Mayer AB, Pfleiderer A, Beul K, Schmidt R, Heitplatz B, Van Marck V, Nolte I, Pavenstädt H, Reuter S, Brand M, Di Marco GS. Increased soluble fms-like tyrosine kinase 1 after ischemia reperfusion contributes to adverse clinical outcomes following kidney transplantation. Kidney Int 2019; 95:1091-1102. [PMID: 30824181 DOI: 10.1016/j.kint.2018.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/05/2018] [Accepted: 11/02/2018] [Indexed: 12/20/2022]
Abstract
Renal ischemia reperfusion injury (IRI) adversely affects clinical outcomes following kidney transplantation. Understanding the cellular mechanisms and the changes in gene/protein expression following IRI may help to improve these outcomes. Serum soluble fms-like tyrosine kinase 1 (sFlt-1), a circulating antiangiogenic protein, is increased in the first week following kidney transplantation. We evaluated the casual relationship of elevated sFlt-1 levels with renal microvascular dysfunction following IRI in a longitudinal study of 93 kidney transplant recipients and in several animal models. Transplant recipients with higher sFlt-1 levels had higher odds of delayed graft function, graft rejection, impaired graft function, and death. In a subgroup of 25 participants who underwent kidney biopsy within 4 months of kidney transplantation, peritubular capillary area was lower in those with elevated serum sFtl-1 levels. The administration of recombinant sFlt-1 into rodents resulted in significant structural and functional changes of the renal microvasculature, including reduced peritubular capillary density and intracapillary blood volume, and lead to increased expression of inflammatory genes and increased fibrosis. In a murine model of IRI, the kidney was a site of sFlt-1 production, and systemic neutralization of sFlt-1 preserved peritubular capillary density and alleviated renal fibrosis. Our data indicate that high sFlt-1 levels after IRI play an important role in the pathogenesis of microvascular dysfunction, thereby contributing to adverse clinical outcomes following kidney transplantation.
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Affiliation(s)
- Theresa M Wewers
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany; Small Animal Hospital, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Anna B Mayer
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Alexander Pfleiderer
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Katrin Beul
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Rene Schmidt
- Institute for Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany
| | - Barbara Heitplatz
- Department of Pathology, University Hospital Münster, Münster, Germany
| | - Veerle Van Marck
- Department of Pathology, University Hospital Münster, Münster, Germany
| | - Ingo Nolte
- Small Animal Hospital, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Hermann Pavenstädt
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Stefan Reuter
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Marcus Brand
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany
| | - Giovana S Di Marco
- Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
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116
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Abstract
Acute kidney injury (AKI) is a frequent complication in hospitalised patients and is diagnosed by urinary output and serum creatinine. Serum creatinine is an indirect marker for renal glomerular filtration, but lacks specificity for damage to kidney tissue and the relatively late response to injury precludes early recognition of AKI. Timely diagnosis of kidney injury using biomarkers that provide information about the aetiology of kidney injury is an unmet clinical need. To overcome the suboptimal performance of serum creatinine, injury biomarkers have been proposed that predict AKI in diverse clinical settings. The clinical performance of these markers is considered moderate due to the lack of specificity for kidney tissue or the underlying injury mechanisms, poor test specificity and confounding by interventions or comorbidities. Hence, it is not unequivocally beneficial to implement current kidney injury biomarkers in the clinical laboratory for diagnostic purposes. In this article we review biomarkers that might fulfil AKI-related unmet clinical needs in the academic hospital setting.
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117
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Feldreich T, Nowak C, Fall T, Carlsson AC, Carrero JJ, Ripsweden J, Qureshi AR, Heimbürger O, Barany P, Stenvinkel P, Vuilleumier N, Kalra PA, Green D, Ärnlöv J. Circulating proteins as predictors of cardiovascular mortality in end-stage renal disease. J Nephrol 2018; 32:111-119. [PMID: 30499038 PMCID: PMC6373380 DOI: 10.1007/s40620-018-0556-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 09/10/2018] [Indexed: 12/14/2022]
Abstract
Introduction Proteomic profiling of end-stage renal disease (ESRD) patients could lead to improved risk prediction and novel insights into cardiovascular disease mechanisms. Plasma levels of 92 cardiovascular disease-associated proteins were assessed by proximity extension assay (Proseek Multiplex CVD-1, Olink Bioscience, Uppsala, Sweden) in a discovery cohort of dialysis patients, the Mapping of Inflammatory Markers in Chronic Kidney disease cohort [MIMICK; n = 183, 55% women, mean age 63 years, 46 cardiovascular deaths during follow-up (mean 43 months)]. Significant results were replicated in the incident and prevalent hemodialysis arm of the Salford Kidney Study [SKS dialysis study, n = 186, 73% women, mean age 62 years, 45 cardiovascular deaths during follow-up (mean 12 months)], and in the CKD5-LD-RTxcohort with assessments of coronary artery calcium (CAC)-score by cardiac computed tomography (n = 89, 37% women, mean age 46 years). Results In age and sex-adjusted Cox regression in MIMICK, 11 plasma proteins were nominally associated with cardiovascular mortality (in order of significance: Kidney injury molecule-1 (KIM-1), Matrix metalloproteinase-7, Tumour necrosis factor receptor 2, Interleukin-6, Matrix metalloproteinase-1, Brain-natriuretic peptide, ST2 protein, Hepatocyte growth factor, TNF-related apoptosis inducing ligand receptor-2, Spondin-1, and Fibroblast growth factor 25). Only plasma KIM-1 was associated with cardiovascular mortality after correction for multiple testing, but also after adjustment for dialysis vintage, cardiovascular risk factors and inflammation (hazard ratio) per standard deviation (SD) increase 1.84, 95% CI 1.26–2.69, p = 0.002. Addition of KIM-1, or nine of the most informative proteins to an established risk-score (modified AROii CVM-score) improved discrimination of cardiovascular mortality risk from C = 0.777 to C = 0.799 and C = 0.823, respectively. In the SKS dialysis study, KIM-1 predicted cardiovascular mortality in age and sex adjusted models (hazard ratio per SD increase 1.45, 95% CI 1.03–2.05, p = 0.034) and higher KIM-1 was associated with higher CACscores in the CKD5-LD-RTx-cohort. Conclusions Our proteomics approach identified plasma KIM-1 as a risk marker for cardiovascular mortality and coronary artery calcification in three independent ESRD-cohorts. The improved risk prediction for cardiovascular mortality by plasma proteomics merit further studies. Electronic supplementary material The online version of this article (10.1007/s40620-018-0556-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tobias Feldreich
- School of Health and Social Studies, Dalarna University, Falun, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Christoph Nowak
- Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Tove Fall
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Axel C Carlsson
- Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Juan-Jesus Carrero
- Department of Medical Epidemiology and Biostatistics (MEB), Karolinska Institutet, Solna, Sweden
| | - Jonas Ripsweden
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Campus Flemingsberg, Stockholm, Sweden
| | - Abdul Rashid Qureshi
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Stockholm, Sweden
| | - Olof Heimbürger
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Stockholm, Sweden
| | - Peter Barany
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska University Hospital, Stockholm, Sweden
| | - Nicolas Vuilleumier
- Department of Genetics, Laboratory Medicine and Pathology, Geneva University Hospitals, Geneva, Switzerland.,Department of Medical Specialties, Geneva Faculty of Medicine, Geneva, Switzerland
| | - Philip A Kalra
- Divison of Cardiovascular Sciences, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.,Department of Renal, Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Darren Green
- Divison of Cardiovascular Sciences, The University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.,Department of Renal, Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Johan Ärnlöv
- School of Health and Social Studies, Dalarna University, Falun, Sweden. .,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
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Gondaliya P, Dasare A, Srivastava A, Kalia K. miR29b regulates aberrant methylation in In-Vitro diabetic nephropathy model of renal proximal tubular cells. PLoS One 2018; 13:e0208044. [PMID: 30496316 PMCID: PMC6264835 DOI: 10.1371/journal.pone.0208044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/09/2018] [Indexed: 01/10/2023] Open
Abstract
The role of DNA methylation has not been enough explored in pathophysiology of diabetic nephropathy (DN). However, according to recent reports it has been inferred that hypermethylation could be one of the principle cause associated with the enhancement of DN. An interrelationship between miR29b and DNA methylation has been studied via in-silico analysis. We have validated that miR29b prominently targets DNA methyl transferase (DNMT), specifically DNMT1, DNMT3A and DNMT3B. We have developed in vitro DN model using renal proximal tubule epithelial cells (RPTECs), contributed to a significant alleviation in RNA and protein expression levels of DNMT3A, DNMT3B and DNMT1. The developed model has also demonstrated downregulation in expression of miR29b. Our studies have also suggested that miR29b targets DNMT1 via targeting its transcription factor SP1. In addition to this, downregulation of a specific biomarker for kidney injury, tubular kidney injury molecule-1 (KIM-1) and fibrosis causing glycoprotein i.e. fibronectin, was also demonstrated. Hence, the developed model revealed that hypermethylation is a key factor incorporated in DN, and miR29b could effectively ameliorate defensive actions in DN pathogenesis.
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Affiliation(s)
- Piyush Gondaliya
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research- Ahmedabad
| | - Aishwarya Dasare
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research- Ahmedabad
| | - Akshay Srivastava
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research- Ahmedabad
| | - Kiran Kalia
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research- Ahmedabad
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Bostan Gayret Ö, Taşdemir M, Erol M, Tekin Nacaroğlu H, Zengi O, Yiğit Ö. Are there any new reliable markers to detect renal injury in obese children? Ren Fail 2018; 40:416-422. [PMID: 30035656 PMCID: PMC6060377 DOI: 10.1080/0886022x.2018.1489284] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIM The aim of this study was to examine the serum and urine levels of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), matrix metalloproteinase-9 (MMP-9), and serum Cystatin-C to determine the renal effect of obesity in obese children. METHODS Seventy-two obese and 35 non-obese healthy children were included in this study. Blood pressure (BP) was evaluated with office measurement. Creatinine, cystatin C, lipids, fasting glucose, and insulin levels were measured, and homeostasis model assessment -insulin resistance (HOMA-IR) was calculated. The urine albumin/creatinine ratio was calculated. The serum and urine KIM-1, NGAL, OPN, and MMP-9 levels were measured. RESULTS Serum cystatin-C, triglyceride, and homeostasis model assessment-insulin resistance (HOMA-IR) index were found to be significantly higher in the obese group (p = .0001), and high-density lipoprotein (HDL) cholesterol was found to be significantly lower (p = .019) in the obese group. No significant differences were found in serum KIM-1, NGAL, OPN or MMP-9 levels between groups (p > .05). No significant differences were found in urine KIM-1 and MMP-9 levels (p > .05), Urine NGAL, and OPN levels were found significantly higher in obese groups (p < .05). CONCLUSIONS According to our results, although serum KIM-1, NGAL, OPN, MMP-9, and urine MMP-9, urine KIM-1 do not appear to be ideal markers to evaluate renal injury in the early period of obesity, the serum levels of cystatin C and urine NGAL, urine OPN can be used as a good marker for assessing the renal effect of obesity which can lead end stage renal disease in pediatric population.
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Affiliation(s)
- Özlem Bostan Gayret
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | - Mehmet Taşdemir
- b Department of Pediatrics, Division of Pediatric Nephrology , Koc University Hospital , Istanbul , Turkey
| | - Meltem Erol
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | | | - Oğuzhan Zengi
- d Department of Biochemistry , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
| | - Özgül Yiğit
- a Department of Pediatrics , Ministry of Health, Bağcılar Training and Research Hospital , Istanbul , Turkey
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120
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Fan H, Zhao Y, Sun M, Zhu JH. Urinary neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, N-acetyl-β-D-glucosaminidase levels and mortality risk in septic patients with acute kidney injury. Arch Med Sci 2018; 14:1381-1386. [PMID: 30393493 PMCID: PMC6209703 DOI: 10.5114/aoms.2018.79006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/30/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The aim of the study was to confirm whether higher levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and N-acetyl-β-D-glucosaminidase (NAG) are associated with mortality risk scores in severe septic patients with acute kidney injury (AKI). MATERIAL AND METHODS A prospective observational study was performed in an adult critical care unit. A total of 135 patients were included. The levels of urinary NGAL, KIM-1 and NAG were compared between patients with acute physiology and chronic health evaluation (APACHE II) score > 25 (group A, n = 31) and APACHE II score ≤ 25 (group B, n = 104). RESULTS Median level of NGAL was 105.1 ng/ml (77.6-132.5) in group A versus 40.0 ng/ml (18.6-60.5) in group B (p < 0.001), KIM-1 was 16.2 ng/ml (10.2-22.3) versus 3.3 ng/ml (1.8-4.6) (p < 0.001), and NAG was 32.0 U/l (17.5-46.4) versus 15.0 U/l (7.7-22.3) (p < 0.001). The area under the receiver operating characteristic curve for NGAL was 0.70 (95% CI: 0.60-0.79), KIM-1 was 0.75 (95% CI: 0.66-0.83), and NAG was 0.69 (95% CI: 0.60-0.79). A NGAL level > 102.5 ng/ml had 95% sensitivity and 76% specificity, KIM-1 > 7.3 ng/ml had 96% sensitivity and 61% specificity, and NAG > 15.4 U/l had 86% sensitivity and 74% specificity. CONCLUSIONS In severe septic AKI patients, high levels of NGAL, KIM-1 and NAG are associated with mortality risk scores. Urinary NGAL, KIM-1 and NAG concentrations higher than 102.5 ng/ml, 7.3 ng/ml and 15.4 U/l respectively may be used to predict increased of death risk scores.
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Affiliation(s)
- Heng Fan
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, China
| | - Yu Zhao
- Department of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo, China
| | - Min Sun
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, China
| | - Jian-Hua Zhu
- Department of Intensive Care Unit, Ningbo First Hospital, Ningbo, China
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Ye HH, Shen G, Luo Q, Zhou FF, Xie XL, Wang CY, Han LN. Early diagnosis of acute kidney injury in aged patients undergoing percutaneous coronary intervention. J Zhejiang Univ Sci B 2018; 19:342-348. [PMID: 29732744 DOI: 10.1631/jzus.b1700427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In aged patients, acute kidney injury (AKI) is a common clinical complication after percutaneous coronary intervention (PCI), highlighting the need for timely and certain diagnosis of this disease. A single centre, nested case-control study was conducted, which assessed the usefulness of urinary liver-type fatty acid-binding protein (uL-FABP), neutrophil gelatinase-associated lipocalin (uNGAL), and kidney injury molecule-1 (uKIM-1) for early detection of AKI. One hundred and thirty-two patients at or over 60 years old undergoing PCI were included. Serum creatinine (SCr) was measured before PCI, 24 and 48 h after PCI; uL-FABP, uNGAL, and uKIM-1 were measured before PCI, 6, 24, and 48 h after PCI. We identified 16 AKI patients and selected 32 control patients matched by admission time (<1 week), age (±5 years), and gender. In the receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUCs) for the relative measurements of uL-FABP, uNGAL, and uKIM-1 were 0.809, 0.867, and 0.512 at 6 h after PCI, and 0.888, 0.840, and 0.676 at 24 h after PCI, respectively. AUC for the combination of uL-FABP and uNGAL was 0.899 at 6 h after PCI, and 0.917 at 24 h after PCI. Thus, measurement of uL-FABP and uNGAL levels at 6 and 24 h after PCI may be useful in detecting AKI in aged patients. Measurement of uKIM-1 levels provides inferior predictive power for early diagnosis of AKI.
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Affiliation(s)
- Hong-Hua Ye
- Department of Cardiology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Gen Shen
- Department of Cardiology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Qun Luo
- Department of Nephrology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Fang-Fang Zhou
- Department of Nephrology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Xiao-Ling Xie
- Department of Cardiology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Chun-Yan Wang
- Department of Cardiology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
| | - Li-Na Han
- Department of Nephrology, Ningbo No. 2 Hospital, Medical School of Ningbo University, Ningbo 315010, China
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122
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Urinary kidney injury molecule-1 in renal disease. Clin Chim Acta 2018; 487:15-21. [PMID: 30201372 DOI: 10.1016/j.cca.2018.09.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 12/19/2022]
Abstract
Kidney injury molecule-1 (KIM-1), a type l transmembrane glycoprotein, is recognized as a potential biomarker for detection of tubular injury in the main renal diseases. Urinary KIM-1 increases rapidly upon the tubular injury, and its levels are associated with the degree of tubular injury, interstitial fibrosis, and inflammation in the injured kidney. Currently, the investigation of kidney diseases is usually performed through the assessment of serum creatinine and urinary albumin. However, these biomarkers are limited for the early detection of changes in renal function. Besides, the tubular injury appears to precede glomerular damage in the pathophysiology of renal diseases. For these reasons, the search for sensitive, specific and non-invasive biomarkers is of interest. Therefore, the purpose of this article is to review the physiological mechanisms of KIM-1, as well to present clinical evidence about the association between elevated urinary KIM-1 levels and the main renal diseases such as chronic kidney disease, diabetic kidney disease, acute kidney injury, and IgA nephropathy.
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Dietary intake of cod protein beneficially affects concentrations of urinary markers of kidney function and results in lower urinary loss of amino acids in obese Zucker fa/fa rats. Br J Nutr 2018; 120:740-750. [DOI: 10.1017/s0007114518002076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AbstractObesity increases the risk for developing kidney disease, and protection of kidneys through changes in diet should be investigated. Fish intake has been associated with reduced risk of developing kidney disease; therefore, we wanted to investigate whether cod protein intake could prevent or delay the development of kidney damage in an obese rat model that spontaneously develops proteinuria and focal segmental glomerulosclerosis. The aim of the study was to investigate any effects of cod protein intake on established markers of kidney function, amino acid composition, protein utilisation and growth in obese Zucker fa/fa rats in the early stage of decreased renal function. Male obese Zucker fa/fa rats (HsdOla:Zucker-Lepr) were fed cod muscle proteins in an amount corresponding to 25 % of dietary protein, with the remaining protein from a casein/whey mixture (COD diet). A control group was fed a diet with a casein/whey mixture as the only protein source (CAS diet). The intervention started when rats were 9–10 weeks old, and the rats were fed these diets for 4 weeks. At the end of the study, rats fed the COD diet had lower urine concentration of cystatin C, T-cell immunoglobulin mucin-1 (TIM-1), amino acids, carbamide, uric acid and ammonium and higher concentrations of creatine, trimethylamine N-oxide, 1-methylhistidine and 3-methylhistidine, lower kidney concentration of TIM-1 and showed better growth when compared with the CAS group. To conclude, cod protein may have the potential to delay the development of kidney damage in young obese Zucker rats and to improve protein utilisation and growth.
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Xu J, Sun L, Sun W, Tian J, Guo H. Targeted Silencing of Kim-1 Inhibits the Growth of Clear Cell Renal Cell Carcinoma Cell Line 786-0 In Vitro and In Vivo. Oncol Res 2018; 26:997-1003. [PMID: 29295730 PMCID: PMC7844727 DOI: 10.3727/096504017x15140544654946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
To investigate the effect of Kim-1 on 786-0 cells in vivo and in vitro, several experiments such as quantitative real-time PCR, Western blot, MTT, colony formation, and flow cytometry were performed to evaluate the biological behavior of 786-0 cells treated with Kim-1 siRNA. Furthermore, the tumor xenograft model was applied to BALB/c nude mice to assess the effect of Kim-1 silencing. Lentivirus-mediated RNAi effectively silenced Kim-1 in 786-0 cells. Kim-1 knockdown significantly inhibited the proliferation and colony formation ability of 786-0 cells (p < 0.01). The cell cycle of 786-0 cells was arrested in the G0/G1 phase (p < 0.01). Early and late apoptosis were significantly increased in the Kim-1 siRNA cells (p < 0.01). In addition, growth of 786-0 cells was significantly inhibited in the Kim-1-silenced mice. In conclusion, knockdown of Kim-1 inhibits the growth of 786-0 cells in vitro and in vivo, indicating that Kim-1 could be used as a potential target for clear cell renal cell carcinoma therapy.
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Affiliation(s)
- Jianping Xu
- Department of Urology, Tumor Hospital of Linyi City, Lanshan, Linyi, Shandong, P.R. China
| | - Liguo Sun
- Department of Urology, Tumor Hospital of Linyi City, Lanshan, Linyi, Shandong, P.R. China
| | - Wei Sun
- Department of Urology, Tumor Hospital of Linyi City, Lanshan, Linyi, Shandong, P.R. China
| | - Jianhai Tian
- Department of Urology, Tumor Hospital of Linyi City, Lanshan, Linyi, Shandong, P.R. China
| | - Huaiyuan Guo
- Department of Urology, Tumor Hospital of Linyi City, Lanshan, Linyi, Shandong, P.R. China
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Yin W, Zhang PL, Macknis JK, Lin F, Bonventre JV. Kidney injury molecule-1 identifies antemortem injury in postmortem adult and fetal kidney. Am J Physiol Renal Physiol 2018; 315:F1637-F1643. [PMID: 30110569 DOI: 10.1152/ajprenal.00060.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is currently no technique to unambiguously diagnose antemortem kidney injury on postmortem examination since postmortem tissue damage and autolysis are common. We assessed the ability to detect kidney injury molecule-1 (KIM-1) expression in adult and fetal kidneys examined at autopsy. In adult kidneys ( n = 52 subjects), we found that the intensity of KIM-1 staining significantly correlated with the antemortem level of serum creatinine, and this was independent of the extent of tissue autolysis. In addition, kidneys from a total of 52 fetal/neonatal subjects, 30 stillborns and 22 liveborns, were assessed for KIM-1 staining. Given that serum creatinine is unreliable and often unavailable in fetuses and newborns, we assessed preterminal hypoxia in fetuses by the presence of squames in pulmonary alveoli and by required intubation. KIM-1 expression correlated with these clinical indexes of hypoxia. The expression of KIM-1 was seen in a majority of the fetal and neonatal autopsy kidneys (77%, 40/52) as early as 16 wk of gestation, even in the presence of autolysis. Thus KIM-1 is a specific and stable marker of antemortem tubular injury in kidneys of adults and fetuses despite postmortem autolysis.
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Affiliation(s)
- Wenqing Yin
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts
| | - Ping L Zhang
- Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Minnesota
| | - Jacqueline K Macknis
- Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, Minnesota
| | - Fan Lin
- Division of Laboratory Medicine, Geisinger Medical Center , Danville, Pennsylvania
| | - Joseph V Bonventre
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts.,Harvard Stem Cell Institute , Cambridge, Massachusetts.,Division of Health Sciences and Technology, Harvard-Massachusetts Institute of Technology , Cambridge, Massachusetts
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Ding Y, Nie LM, Pang Y, Wu WJ, Tan Y, Yu F, Zhao MH. Composite urinary biomarkers to predict pathological tubulointerstitial lesions in lupus nephritis. Lupus 2018; 27:1778-1789. [PMID: 30020021 DOI: 10.1177/0961203318788167] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective This study aimed to evaluate the clinical value of urinary biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein-1 (MCP-1) in lupus nephritis. Methods A total of 109 biopsy-proven lupus nephritis patients were included and 50 healthy individuals were used as normal controls. Urinary KIM-1, NGAL, and MCP-1 levels were measured by ELISA and their correlations with clinical and histological features were assessed. Receiver operating characteristic curves were performed and the Cox regression model was applied to identify prognostic factors associated with renal outcomes. Results Active lupus nephritis patients exhibited elevated urinary levels of KIM-1, NGAL, and MCP-1 compared with lupus nephritis patients in remission ( P < 0.001) and normal controls ( P < 0.001). The urinary KIM-1 level was correlated with pathological tubular atrophy ( r = 0.208, P < 0.05) and increased significantly in the presence of interstitial inflammatory lesions ( P = 0.031). Urinary KIM-1, NGAL, and MCP-1 levels were higher in patients with active tubulointerstitial lesions than in those with only chronic lesions ( P = 0.015, P = 0.230, and P = 0.086, respectively). A combination of KIM-1, NGAL, and MCP-1 was a good indicator for diagnosing active tubulointerstitial lesions (area under the curve: 0.796). The combination of KIM-1 and NGAL was identified as an independent risk factor for renal outcomes (hazard ratio = 7.491, P < 0.05). Conclusion Urinary KIM-1, NGAL, and MCP-1 levels were associated with kidney injury indices in lupus nephritis. The combination of the three biomarkers showed increased power in predicting tubulointerstitial lesions and renal outcomes.
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Affiliation(s)
- Y Ding
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,2 Department of Nephrology, Peking University International Hospital, Beijing, PR China
| | - L-M Nie
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,3 Renal Division, Department of Medicine, First Hospital of Shijiazhuang, Shijiazhuang, Hebei, PR, China
| | - Y Pang
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,4 Institute of Nephrology, Peking University, Beijing, PR China.,5 Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China.,6 Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, PR China
| | - W-J Wu
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,4 Institute of Nephrology, Peking University, Beijing, PR China.,5 Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China.,6 Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, PR China.,7 Peking-Tsinghua Center for Life Sciences; Beijing, PR China
| | - Y Tan
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,4 Institute of Nephrology, Peking University, Beijing, PR China.,5 Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China.,6 Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, PR China
| | - F Yu
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,2 Department of Nephrology, Peking University International Hospital, Beijing, PR China.,4 Institute of Nephrology, Peking University, Beijing, PR China.,5 Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China.,6 Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, PR China
| | - M-H Zhao
- 1 Renal Division, Department of Medicine, Peking University First Hospital, Beijing, PR China.,4 Institute of Nephrology, Peking University, Beijing, PR China.,5 Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, PR China.,6 Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, PR China.,7 Peking-Tsinghua Center for Life Sciences; Beijing, PR China
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Bank JR, van der Pol P, Vreeken D, Monge-Chaubo C, Bajema IM, Schlagwein N, van Gijlswijk DJ, van der Kooij SW, Reinders MEJ, de Fijter JW, van Kooten C. Kidney injury molecule-1 staining in renal allograft biopsies 10 days after transplantation is inversely correlated with functioning proximal tubular epithelial cells. Nephrol Dial Transplant 2018; 32:2132-2141. [PMID: 29045706 DOI: 10.1093/ndt/gfx286] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/21/2017] [Indexed: 01/21/2023] Open
Abstract
Background Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are promising biomarkers for monitoring delayed graft function (DGF) after kidney transplantation. Here we investigated localization and distribution of KIM-1 and NGAL staining in renal allograft biopsies and studied their association with histological features, functional DGF (fDGF) and the tubular function slope (TFS), a functioning proximal tubular epithelial cell (PTEC) marker. Methods Day 10 protocol biopsies of 64 donation after circulatory death recipients were stained for KIM-1 and NGAL and the positive area was quantified using ImageJ software. Biopsies were scored according to Banff and acute tubular necrosis (ATN) criteria. A 99mtechnetium-mercaptoacetyltriglycine (99mTc-MAG3)-renography was performed to calculate TFS. Results KIM-1 staining was located on the brush border of tubular epithelial cells (TECs) and correlated with denudation, while NGAL was present more focally in a cytoplasmic distribution. KIM-1 and NGAL staining were not correlated and no co-localization was observed. Quantitative stainings were not associated with fDGF, but KIM-1 tended to be higher in patients with prolonged fDGF (≥21 days; P = 0.062). No correlation was observed between the quantitative tissue stainings and urinary KIM-1 or NGAL. Quantitative KIM-1 staining was inversely correlated with the TFS (Spearman's ρ = -0.53; P < 0.001), whereas NGAL was not. The latter finding might be because cortical NGAL staining is dependent on filtration and subsequent reabsorption by functioning PTECs. Staining of NGAL was indeed restricted to PTECs, as shown by co-localization with a PTEC-specific lectin. Conclusions KIM-1 and NGAL staining showed different localization and distribution. Quantitative KIM-1 staining was inversely correlated with functioning PTECs.
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Affiliation(s)
- Jonna R Bank
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Pieter van der Pol
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Dianne Vreeken
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Catherine Monge-Chaubo
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ingeborg M Bajema
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole Schlagwein
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Daniëlle J van Gijlswijk
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sandra W van der Kooij
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marlies E J Reinders
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johan W de Fijter
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cees van Kooten
- Department of Internal Medicine/Nephrology, Leiden University Medical Center, Leiden, The Netherlands
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Kane-Gill SL, Smithburger PL, Kashani K, Kellum JA, Frazee E. Clinical Relevance and Predictive Value of Damage Biomarkers of Drug-Induced Kidney Injury. Drug Saf 2018; 40:1049-1074. [PMID: 28674842 DOI: 10.1007/s40264-017-0565-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Nephrotoxin exposure accounts for up to one-fourth of acute kidney injury episodes in hospitalized patients, and the associated consequences are as severe as acute kidney injury due to other etiologies. As the use of nephrotoxic agents represents one of the few modifiable risk factors for acute kidney injury, clinicians must be able to identify patients at high risk for drug-induced kidney injury rapidly. Recently, significant advancements have been made in the field of biomarker utilization for the prediction and detection of acute kidney injury. Such biomarkers may have a role both for detection of drug-induced kidney disease and implementation of preventative and therapeutic strategies designed to mitigate injury. In this article, basic principles of renal biomarker use in practice are summarized, and the existing evidence for six markers specifically used to detect drug-induced kidney injury are outlined, including liver-type fatty acid binding protein, neutrophil gelatinase-associated lipocalin, tissue inhibitor of metalloproteinase-2 times insulin-like growth factor-binding protein 7 ([TIMP-2]·[IGFBP7]), kidney injury molecule-1 and N-acetyl-β-D-glucosaminidase. The results of the literature search for these six kidney damage biomarkers identified 29 unique articles with none detected for liver-type fatty acid binding protein and [TIMP-2]·[IGFBP7]. For three biomarkers, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and N-acetyl-β-D-glucosaminidase, the majority of the studies suggest utility in clinical practice. While many questions need to be answered to clearly articulate the use of biomarkers to predict drug-induced kidney disease, current data are promising.
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Affiliation(s)
- Sandra L Kane-Gill
- Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 638 Salk Hall, 3501, Terrace St., Pittsburgh, PA, 15261, USA. .,The Center for Critical Care Nephology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Pamela L Smithburger
- Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 638 Salk Hall, 3501, Terrace St., Pittsburgh, PA, 15261, USA.,University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kianoush Kashani
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - John A Kellum
- The Center for Critical Care Nephology, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,University of Pittsburgh Medical Center, Pittsburgh, PA, USA.,CRISMA (Clinical Research, Investigation and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Erin Frazee
- Department of Pharmacy and Medicine, Mayo Clinic, Rochester, MN, USA
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Greenberg JH, Devarajan P, Thiessen-Philbrook HR, Krawczeski C, Parikh CR, Zappitelli M. Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery. Pediatr Nephrol 2018; 33:1069-1077. [PMID: 29511889 PMCID: PMC5945328 DOI: 10.1007/s00467-018-3888-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/22/2017] [Accepted: 01/08/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. METHODS Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase-associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. RESULTS Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. CONCLUSIONS Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.
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Affiliation(s)
- Jason H Greenberg
- Department of Pediatrics, Section of Nephrology, Yale University School of Medicine, New Haven, CT, USA.
- Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT, USA.
| | - Prasad Devarajan
- Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Catherine Krawczeski
- Department of Pediatrics, Division of Cardiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Chirag R Parikh
- Program of Applied Translational Research, Yale University School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, CT, USA
- VA Medical Center, West Haven, CT, USA
| | - Michael Zappitelli
- Department of Pediatrics, Division of Nephrology, Toronto Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
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Abstract
Chronic kidney disease (CKD) has become a significant public health concern, as it is associated with substantial morbidity. Prior research has evaluated multiple novel CKD biomarkers to supplement serum creatinine and proteinuria. The ultimate goal of this research is to find biomarkers that can be used to accurately predict CKD progression and to better time outpatient follow-up, and referral for transplant. Also, an optimal panel of biomarkers can augment the predictive value of proteinuria and serum creatinine by enriching patient enrollment in clinical trials. In this review, we discuss salient findings on 12 candidate plasma and urine biomarkers and their reported association with CKD. We explore the common pathways of CKD progression and the pathophysiologic processes of tubulointerstitial injury, inflammation, repair, and fibrosis that are potentially classified by specific biomarkers. We describe both pediatric and adult findings and highlight the paucity of pediatric research in CKD progression. It will be important for cohorts with longitudinal follow-up to evaluate these CKD biomarkers for potential use in pediatric clinical trials and routine CKD management.
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Bongers CCWG, Alsady M, Nijenhuis T, Tulp ADM, Eijsvogels TMH, Deen PMT, Hopman MTE. Impact of acute versus prolonged exercise and dehydration on kidney function and injury. Physiol Rep 2018; 6:e13734. [PMID: 29890037 PMCID: PMC5995308 DOI: 10.14814/phy2.13734] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 05/18/2018] [Accepted: 05/18/2018] [Indexed: 01/17/2023] Open
Abstract
Exercise and dehydration may be associated with a compromised kidney function and potential signs of kidney injury. However, the kidney responses to exercise of different durations and hypohydration levels are not yet known. Therefore, we aimed to compare the effects of acute versus prolonged exercise and dehydration on estimated glomerular filtration rate (eGFR) and kidney injury biomarkers in healthy male adults. A total of 35 subjects (23 ± 3 years) were included and invited for two study visits. Visit 1 consisted of a maximal cycling test. On Visit 2, subjects performed a submaximal exercise test at 80% of maximal heart rate until 3% hypohydration. Blood and urine samples were taken at baseline, after 30 min of exercise (acute effects; low level of hypohydration) and after 150 min of exercise or when 3% hypohydration was achieved (prolonged effects, high level of hypohydration). Urinary outcome parameters were corrected for urinary cystatin C, creatinine, and osmolality. Subjects dehydrated on average 0.6 ± 0.3% and 2.9 ± 0.7% after acute and prolonged exercise, respectively (P < 0.001). The eGFRcystatin C did not differ between baseline and acute exercise (118 ± 11 vs. 116 ± 12 mL/min/1.73 m2 , P = 0.12), whereas eGFRcystatin C was significantly lower after prolonged exercise (103 ± 16 mL/min/1.73 m2 , P < 0.001). We found no difference in osmolality corrected uKIM1 concentrations after acute and prolonged exercise (P > 0.05), and elevated osmolality corrected uNGAL concentrations after acute and prolonged exercise (all P-values < 0.05). In conclusion, acute exercise did barely impact on eGFRcystatin C and kidney injury biomarkers, whereas prolonged exercise is associated with a decline in eGFRcystatin C and increased biomarkers for kidney injury.
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Affiliation(s)
- Coen C. W. G. Bongers
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Mohammad Alsady
- Department of PhysiologyRadboud Institute for Molecular Life SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Tom Nijenhuis
- Department of NephrologyRadboud Institute for Molecular Life SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Anouk D. M. Tulp
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Thijs M. H. Eijsvogels
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
- Research Institute for Sports and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Peter M. T. Deen
- Department of PhysiologyRadboud Institute for Molecular Life SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Maria T. E. Hopman
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
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Sugiyama M. Measurement of urinary biomarkers in a case of tubulointerstitial nephritis and uveitis syndrome during glucocorticoid treatment. CEN Case Rep 2018; 7:221-224. [PMID: 29761376 DOI: 10.1007/s13730-018-0330-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/16/2018] [Indexed: 01/22/2023] Open
Abstract
Tubulointerstitial nephritis and uveitis (TINU) is a rare syndrome in which idiopathic interstitial nephritis coexists with chronic recurrent uveitis. This syndrome often represents systemic disorders such as arthralgia, rash, prolonged fever, anaemia and ocular symptoms that require medication including glucocorticoid administration. Recently, novel urinary biomarkers, such as kidney injury molecule-1, neutrophil gelatinase-associated lipocalin and liver-type fatty acid-binding protein, were shown to be associated with tubulointerstitial damage and were elevated in interstitial nephritis. We evaluated these urinary biomarkers in a case of TINU syndrome before and during treatment and found that their levels were elevated at onset and decreased during treatment, especially NGAL. We conclude that these urinary biomarkers are useful to evaluate and predict prognosis in interstitial nephritis.
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Affiliation(s)
- Masafumi Sugiyama
- Department of Nephrology and Rheumatology, Hashima Municipal Hospital, 3-246 Shinsei-cho, Hashima, Gifu, 501-6206, Japan.
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CERA Attenuates Kidney Fibrogenesis in the db/db Mouse by Influencing the Renal Myofibroblast Generation. J Clin Med 2018; 7:jcm7020015. [PMID: 29385703 PMCID: PMC5852431 DOI: 10.3390/jcm7020015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/24/2018] [Accepted: 01/24/2018] [Indexed: 12/24/2022] Open
Abstract
Tubulointerstitial fibrosis (TIF) is a pivotal pathophysiological process in patients with diabetic nephropathy (DN). Multiple profibrotic factors and cell types, including transforming growth factor beta 1 (TGF-β1) and interstitial myofibroblasts, respectively, are responsible for the accumulation of extracellular matrix in the kidney. Matrix-producing myofibroblasts can originate from different sources and different mechanisms are involved in the activation process of the myofibroblasts in the fibrotic kidney. In this study, 16-week-old db/db mice, a model for type 2 DN, were treated for two weeks with continuous erythropoietin receptor activator (CERA), a synthetic erythropoietin variant with possible non-hematopoietic, tissue-protective effects. Non-diabetic and diabetic mice treated with placebo were used as controls. The effects of CERA on tubulointerstitial fibrosis (TIF) as well as on the generation of the matrix-producing myofibroblasts were evaluated by morphological, immunohistochemical, and molecular biological methods. The placebo-treated diabetic mice showed significant signs of beginning renal TIF (shown by picrosirius red staining; increased connective tissue growth factor (CTGF), fibronectin and collagen I deposition; upregulated KIM1 expression) together with an increased number of interstitial myofibroblasts (shown by different mesenchymal markers), while kidneys from diabetic mice treated with CERA revealed less TIF and fewer myofibroblasts. The mechanisms, in which CERA acts as an anti-fibrotic agent/drug, seem to be multifaceted: first, CERA inhibits the generation of matrix-producing myofibroblasts and second, CERA increases the ability for tissue repair. Many of these CERA effects can be explained by the finding that CERA inhibits the renal expression of the cytokine TGF-β1.
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Satirapoj B. Tubulointerstitial Biomarkers for Diabetic Nephropathy. J Diabetes Res 2018; 2018:2852398. [PMID: 29577044 PMCID: PMC5822931 DOI: 10.1155/2018/2852398] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/29/2017] [Accepted: 01/04/2018] [Indexed: 12/22/2022] Open
Abstract
Patients with diabetic nephropathy have a higher risk of mortality, mostly from cardiovascular complications. Standard biomarkers including serum creatinine, estimated glomerular filtration rate, and albuminuria are imprecise, do not directly measure renal tissue injury, and are relatively insensitive to small changes in renal function. Thus, availability of novel biomarkers that are sensitive, specific, and precise as well as able to detect kidney injury and predict clinically significant outcomes would be widely useful in diabetic nephropathy. Novel biomarkers of the processes that induce tubulointerstitial changes may ultimately prove to better predict renal progression and prognosis in type 2 diabetes. Recently, certain biomarkers, which were initially identified in acute kidney injury, also have been reported to confer value in evaluating patients with chronic kidney disease. Biomarkers such as cystatin C, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), angiotensinogen, periostin, and monocyte chemoattractant protein-1 (MCP-1) reflect tubular injury. In this article, we focused on the potential applications of these biomarkers in diabetic nephropathy.
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Affiliation(s)
- Bancha Satirapoj
- Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
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136
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Bongers CCWG, Alsady M, Nijenhuis T, Hartman YAW, Eijsvogels TMH, Deen PMT, Hopman MTE. Impact of acute versus repetitive moderate intensity endurance exercise on kidney injury markers. Physiol Rep 2017; 5:e13544. [PMID: 29263119 PMCID: PMC5742704 DOI: 10.14814/phy2.13544] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 11/19/2017] [Indexed: 11/30/2022] Open
Abstract
Exercise may lead to kidney injury through several mechanisms. Urinary Kidney Injury Molecule-1 (uKIM1) and Neutrophil Gelatinase-Associated Lipocalin (uNGAL) are known biomarkers for acute kidney injury, but their response to repetitive exercise remains unknown. We examined the effects of a single versus repetitive bouts of exercise on markers for kidney injury in a middle-aged population. Sixty subjects (aged 29-78 years, 50% male) were included and walked 30, 40 or 50 km for three consecutive days. At baseline and after exercise day 1 and 3, a urine sample was collected to determine uNGAL and uKIM1. Furthermore, urinary cystatin C, creatinine, and osmolality were used to correct for dehydration-related changes in urinary concentration. Baseline uNGAL was 9.2 (5.2-14.7) ng/mL and increased to 20.7 (11.0-37.2) ng/mL and 14.2(8.0-26.3) ng/mL after day 1 and day 3, respectively, (P ≤ 0.001). Baseline uKIM1 concentration was 2.6 (1.4-6.0) ng/mL and increased to 5.2 (2.4-9.1) ng/mL (P = 0.002) after day 1, whereas uKIM1 was not different from baseline at day 3 (2.9 [1.4-6.4] ng/mL (P = 0.52)). Furthermore, both uNGAL and uKIM1 levels were higher after day 1 compared to day 3 (P < 0.01). When corrected for urinary cystatin C, creatinine, and osmolality, uNGAL demonstrated a similar response compared to the uncorrected data, whereas differences in uKIM1 between baseline, day 1 and day 3 (Ptime = 0.63) were no longer observed for cystatin C and creatinine corrected data. A single bout of prolonged exercise significantly increased uNGAL concentration, whereas no changes in uKIM1 were found. Repetitive bouts of exercise show that there is no cumulative effect of kidney injury markers.
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Affiliation(s)
- Coen C. W. G. Bongers
- Department of PhysiologyRadboud Institute for Health SciencesRadboud university medical centerNijmegenThe Netherlands
| | - Mohammad Alsady
- Department of PhysiologyRadboud Institute for Molecular Life SciencesRadboud university medical centerNijmegenThe Netherlands
| | - Tom Nijenhuis
- Department of NephrologyRadboud Institute for Molecular Life SciencesRadboud university medical centerNijmegenThe Netherlands
| | - Yvonne A. W. Hartman
- Department of PhysiologyRadboud Institute for Health SciencesRadboud university medical centerNijmegenThe Netherlands
| | - Thijs M. H. Eijsvogels
- Department of PhysiologyRadboud Institute for Health SciencesRadboud university medical centerNijmegenThe Netherlands
- Research Institute for Sports and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Peter M. T. Deen
- Department of PhysiologyRadboud Institute for Molecular Life SciencesRadboud university medical centerNijmegenThe Netherlands
| | - Maria T. E. Hopman
- Department of PhysiologyRadboud Institute for Health SciencesRadboud university medical centerNijmegenThe Netherlands
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137
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Zhang Y, Li A, Wen J, Zhen J, Hao Q, Zhang Y, Hu Z, Xiao X. Kidney Injury Molecule-1 Level is Associated with the Severity of Renal Interstitial Injury and Prognosis in Adult Henoch-Schönlein Purpura Nephritis. Arch Med Res 2017; 48:449-458. [PMID: 29122357 DOI: 10.1016/j.arcmed.2017.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 10/17/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Kidney injury molecule-1 (KIM-1) was identified the most highly upregulated protein in chronic kidney diseases and prolonged KIM-1 expression may be maladaptive. The present study was aimed to investigate urinary, renal and plasma KIM-1 levels and to analyze association between KIM-1 levels with clinical and pathological indexes in adult Henoch-Schönlein purpura (HSP) patients. METHODS Twenty healthy individuals, 20 HSP patients without nephritis and 35 HSP patients with nephritis were recruited. Urinary and plasma KIM-1 levels were determined by ELISA and Luminex, respectively. Renal KIM-1 expression was evaluated by immunohistochemistry. RESULTS HSP patients with nephritis were characterized as elevated levels of urinary, renal and plasma KIM-1. Those with more severe tubular injury of renal biopsy tissues presented significantly higher urinary and renal KIM-1 levels compared to control and patients without nephritis. Urinary and renal levels of KIM-1 were positively correlated with blood urea nitrogen and proteinuria, while they were negatively correlated with eGFR at both baseline and after two years follow-up. Moreover, plasma KIM-1 levels were associated with blood urea nitrogen and proteinuria as well. Further univariate correlation analysis indicated urinary and renal KIM-1 levels were positively correlated with interstitial inflammation index and tubulointerstitial chronicity index. Only urinary KIM-1 levels were associated with interstitial inflammation index, tubulointerstitial chronicity index and extracapillary glomerular activity index, after logistic regression analysis. The area under the curve (AUC) for urinary KIM-1/Cr predicting progression of renal damage was significantly greater than the AUC for proteinuria. CONCLUSIONS This finding suggests that measurement of urinary and renal KIM-1 level may be helpful to evaluate severity of renal pathological damage and prognosis in adult HSP patients with nephritis.
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Affiliation(s)
- Yuanyuan Zhang
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China
| | - Aiju Li
- Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Jiliang Wen
- Department of Urology, the Second Hospital of Shandong University, Jinan, China
| | - Junhui Zhen
- Department of Pathology, Qilu Hospital of Shandong University, Jinan, China
| | - Qiufa Hao
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China
| | - Yidan Zhang
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhao Hu
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaoyan Xiao
- Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China.
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138
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Futrakul N, Futrakul P. Biomarker for early renal microvascular and diabetic kidney diseases. Ren Fail 2017; 39:505-511. [PMID: 28494191 PMCID: PMC6014362 DOI: 10.1080/0886022x.2017.1323647] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/20/2017] [Accepted: 04/23/2017] [Indexed: 12/20/2022] Open
Abstract
Recognition of early stage of diabetic kidney disease, under common practice using biomarkers, namely microalbuminuria, serum creatinine level above 1 mg/dL and accepted definition of diabetic kidney disease associated with creatinine clearance value below 60 mL/min/1.73 m2, is unlikely. This would lead to delay treatment associated with therapeutic resistance to vasodilator due to a defective vascular homoeostasis. Other alternative biomarkers related to the state of microalbuminuria is not sensitive to screen for early diabetic kidney disease (stages I, II). In this regard, a better diagnostic markers to serve for this purpose are creatinine clearance, fractional excretion of magnesium (FE Mg), cystatin C. Recently, renal microvascular disease and renal ischemia have been demonstrated to correlate indirectly with the development of diabetic kidney disease and its function. Among these are angiogenic and anti-angiogenic factors, namely VEGF, VEGF receptors, angiopoietins and endostatin. With respect to therapeutic prevention, implementation of treatment at early stage of diabetic and nondiabetic kidney disease is able to restore renal perfusion and function.
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Affiliation(s)
- Narisa Futrakul
- Department of Physiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
| | - Prasit Futrakul
- Academy of Science, The Royal Institute of Thailand and Bhumirajanagarindra Kidney Institute, Bangkok, Thailand
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139
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Arany I, Hall S, Dixit M. Age-dependent sensitivity of the mouse kidney to chronic nicotine exposure. Pediatr Res 2017; 82:822-828. [PMID: 28665927 DOI: 10.1038/pr.2017.153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/03/2017] [Indexed: 01/02/2023]
Abstract
BackgroundMany adolescents are exposed to nicotine via smoking, e-cigarette use, or second-hand smoke. Nicotine-induced renal oxidative stress and its long-term consequences may be higher in adolescents than in adults because of intrinsic factors in the adolescent kidney.MethodsAdolescent and adult male C57Bl/6J mice were subjected to 2 or 200 μg/ml nicotine, which closely emulates passive or active smoking, respectively, for 4 weeks. Extent of nicotine exposure (cotinine content), oxidative stress (HNE), renal function (creatinine), tubular injury (KIM-1), and pretreatment renal levels of select pro-oxidant (p66shc) and antioxidant (Nrf2/MnSOD) genes were determined. Impact of p66shc overexpression or Nrf2/MnSOD knockdown on low-/high-dose nicotine-induced oxidative stress was determined in cultured renal proximal tubule cells.ResultsDespite similar plasma/renal cotinine levels, renal HNE and KIM-1 contents were higher in adolescents compared with those in adults, whereas renal function was unaltered after passive or active smoking-equivalent nicotine exposure. Pretreatment levels of p66shc were higher, whereas Nrf2/MnSOD levels were lower in the adolescent kidney. In agreement with this, overexpression of p66shc or knockdown of Nrf2/MnSOD augmented nicotine-induced ROS production in renal proximal tubule cells.ConclusionChronic nicotine exposure incites higher oxidative stress in the adolescent than in adult kidney because of a pre-existent pro-oxidant milieu.
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Affiliation(s)
- Istvan Arany
- Department of Pediatrics, Division of Pediatric Nephrology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Samuel Hall
- Department of Pediatrics, Division of Pediatric Nephrology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Mehul Dixit
- Department of Pediatrics, Division of Pediatric Nephrology, University of Mississippi Medical Center, Jackson, Mississippi
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140
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Zhang K, Li GQ, He QH, Li Y, Tang M, Zheng QY, Xu GL, Zhang KQ. C5a/C5aR pathway accelerates renal ischemia-reperfusion injury by downregulating PGRN expression. Int Immunopharmacol 2017; 53:17-23. [PMID: 29031143 DOI: 10.1016/j.intimp.2017.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/22/2017] [Accepted: 10/05/2017] [Indexed: 12/26/2022]
Abstract
Recent reports indicate that the complement C5a/C5aR pathway and progranulin (PGRN) deficiency both contribute to ischemia-reperfusion (IR)-induced acute kidney injury. However, the underlying relationship between the C5a/C5aR signaling pathway and PGRN expression during acute kidney injury is poorly understood. In this study, we showed that C5aR expression was significantly upregulated after renal IR, and that C5aR deficiency led to a marked increase in PGRN expression and a significant reduction in tubular damage and production of inflammatory cytokines. In accordance with these results, recombinant C5a caused downregulation of PGRN protein and mRNA levels in renal tubular epithelial cells (HK-2 cells), which could be negated by disruption of C5a/C5aR signaling by the C5aR antagonist, as confirmed by immunofluorescence, western blotting, and quantitative real-time PCR. Moreover, C5aR deficiency resulted in attenuated NF-κB expression 24h after IR, and recombinant C5a potentiated TNFα-induced NF-κB activation in HK-2 cells. Inhibition of NF-κB activation reversed C5a-induced downregulation of PGRN expression. Our results show for the first time that the complement C5a/C5aR pathway aggravates IR-induced acute kidney injury by suppressing PGRN expression and confirm that suppression of PGRN expression is associated with increased NF-κB activation induced by C5a.
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Affiliation(s)
- Kun Zhang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Gui-Qing Li
- Department of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Qian-Hui He
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - You Li
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Ming Tang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Quan-You Zheng
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
| | - Gui-Lian Xu
- Department of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Ke-Qin Zhang
- Department of Nephrology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
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141
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Papadopoulou-Marketou N, Kanaka-Gantenbein C, Marketos N, Chrousos GP, Papassotiriou I. Biomarkers of diabetic nephropathy: A 2017 update. Crit Rev Clin Lab Sci 2017; 54:326-342. [DOI: 10.1080/10408363.2017.1377682] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Nektaria Papadopoulou-Marketou
- Diabetes Centre of the Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
- Department of Endocrinology, Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden
| | - Christina Kanaka-Gantenbein
- Diabetes Centre of the Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | | | - George P. Chrousos
- Diabetes Centre of the Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, Athens, Greece
| | - Ioannis Papassotiriou
- Department of Clinical Biochemistry, “Aghia Sophia” Children’s Hospital, Athens, Greece
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142
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Lin YF, Lee YH, Hsu YH, Chen YJ, Lin YF, Cheng FY, Chiu HW. Resveratrol-loaded nanoparticles conjugated with kidney injury molecule-1 as a drug delivery system for potential use in chronic kidney disease. Nanomedicine (Lond) 2017; 12:2741-2756. [PMID: 28884615 DOI: 10.2217/nnm-2017-0256] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM We used resveratrol (Res)-loaded nanoparticles (Res NPs) as a novel method for improving the pharmacokinetic properties of Res and analyzed the effect of Res NPs in chronic kidney disease (CKD). MATERIALS & METHODS We coupled anti-kidney injury molecule-1 antibodies to Res NPs and analyzed safety and efficacy. RESULTS Res NPs had low toxicity and induced autophagy. Res NPs inhibited the NLRP3 inflammasome and IL-1β secretion. Higher NLRP3 expression levels were observed in peripheral blood monocytic cells of CKD patients than healthy individuals. Treatment with kidney injury molecule-1-Res NPs significantly reduced creatinine and protected against tubulointerstitial injury in a murine model of CKD. CONCLUSION Res NPs through NLRP3 inflammasome attenuation and autophagy induction may be as a strategy to prevent CKD.
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Affiliation(s)
- Yuh-Feng Lin
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Hsuan Lee
- Department of Food Safety/Hygiene & Risk Management, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Ho Hsu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Jie Chen
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - Yuan-Feng Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Fong-Yu Cheng
- Department of Chemistry, Chinese Culture University, Taipei, Taiwan
| | - Hui-Wen Chiu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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143
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Kashani K, Cheungpasitporn W, Ronco C. Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption. Clin Chem Lab Med 2017; 55:1074-1089. [PMID: 28076311 DOI: 10.1515/cclm-2016-0973] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022]
Abstract
Acute kidney injury (AKI) is a common complication of critical illnesses and has a significant impact on outcomes, including mortality and morbidities. Unfortunately, apart from prophylactic measures, no effective treatment for this syndrome is known. Therefore, early recognition of AKI not only can provide better opportunities for preventive interventions, but also opens many gates for research and development of effective therapeutic options. Over the last few years, several new AKI biomarkers have been discovered and validated to improve early detection, differential diagnosis, and differentiation of patients into risk groups for progressive renal failure, need for renal replacement therapy (RRT), or death. These novel AKI biomarkers complement serum creatinine (SCr) and urine output, which are the standard diagnostic tools for AKI detection. In this article, we review the available literature on characteristics of promising AKI biomarkers that are currently the focus of preclinical and clinical investigations. These biomarkers include neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1), liver-type fatty acid-binding protein, interleukin 18 (lL-18), insulin-like growth factor-binding protein 7, tissue inhibitor of metalloproteinase 2 (TIMP-2), calprotectin, urine angiotensinogen (AGT), and urine microRNA. We then describe the clinical performance of these biomarkers for diagnosis and prognostication. We also appraise each AKI biomarker's advantages and limitations as a tool for early AKI recognition and prediction of clinical outcomes after AKI. Finally, we review the current and future states of implementation of biomarkers in the clinical practice.
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144
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Bulanov NM, Serova AG, Kuznetsova EI, Bulanova ML, Novikov PI, Kozlovskaya LV, Moiseev SV. [Kidney injury molecules (KIM-1, MCP-1) and type IV collagen in the assessment of activity of antineutrophil cytoplasmic antibody-associated glomerulonephritis]. TERAPEVT ARKH 2017; 89:48-55. [PMID: 28745689 DOI: 10.17116/terarkh201789648-55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM To assess the significance of determining the serum and urinary concentrations of monocyte chemotactic protein-1 (MCP-1), kidney injury molecule-1 (KIM-1), and type IV collagen in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) to estimate the activity of renal involvement in AAV. SUBJECTS AND METHODS 78 patients (32 men and 46 women) (median age 55 (45; 61) years) with AAV were examined. The patients were divided into 3 groups according to the AAV activity estimated using the Birmingham vasculitis activity Score (BVAS): 1) 25 patients with active ANCA-associated glomerulonephritis (GN); 2) 26 patients with active AAV without renal involvement; 3) 27 patients in sustained AAV remission. The serum and urinary concentrations of the markers were measured by enzyme immunoassay. RESULTS The urinary concentration of all 3 biomarkers was higher in patients with renal involvement (Group 1); the differences in the levels of MCP-1 and type IV collagen were statistically significant as compared to Groups 2 and 3 (p<0.01), while that in KIM-1 level was only in Group 2. There were statistically significant correlations between the urinary concentration of these biomarkers and the traditional GN activity indices (erythrocyturia, daily proteinuria (DPU), total BVAS scores that reflect renal involvement, as well as serum creatinine levels and estimated glomerular filtration rate (p<0.05). ROC curve analysis showed that the urinary MCP-1 excretion of ≥159 pg/ml had the highest (92%) sensitivity and urinary type IV collagen excretion of ≥3.09 µg/l had the highest (86%) specificity in assessing the activity of ANCA-associated GN. At the same time, their diagnostic value increased in terms of a combination of DPU and ESR (96% sensitivity, 84.9% specificity). CONCLUSION The urinary excretion of MCP-1, KIM-1, and type IV collagen reflects the severity of local renal inflammation in AAV patients and a study of these indicators is a promising diagnostic tool for assessing the activity of ANCA-associated GN.
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Affiliation(s)
- N M Bulanov
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - A G Serova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - E I Kuznetsova
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - M L Bulanova
- Vladimir Regional Clinical Hospital, Vladimir, Russia
| | - P I Novikov
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - L V Kozlovskaya
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
| | - S V Moiseev
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
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145
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High expression of TIM-3 and KIM-1 in blood and urine of renal allograft rejection patients. Transpl Immunol 2017; 43-44:11-20. [PMID: 28757398 DOI: 10.1016/j.trim.2017.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND T cell immunoglobulin and mucin domain 3 (TIM-3) is involved in alloimmune and autoimmune responses, as well as tolerance induction in kidney transplantation. Kidney injury molecule-1 (KIM-1) is highly expressed in epithelial cells of the injured proximal tubule. In this study, we have investigated both urinary and blood TIM-3 mRNA expressions, urinary KIM-1 mRNA expression, and urinary and serum KIM-1 proteins in renal allograft recipients diagnosed with acute allograft rejection (AR) and chronic allograft dysfunction (CAD), as well as those with well-functioning transplants (WFG). METHODS We divided 85 patients into the following groups: AR (n=24), CAD (n=19), and WFG (n=42). TIM-3 and KIM-1 mRNA expressions were quantified using real-time reverse-transcription TaqMan probe polymerase chain reaction (RT-PCR). An ELISA test was used to measure the amount of KIM-1 protein in serum and urine samples. RESULTS AR and CAD patients had significantly greater urinary and blood TIM-3 mRNA expressions, urinary KIM-1 mRNA expression, and urinary and serum KIM-1 proteins compared to WFG patients. Receiver operating characteristic (ROC) analysis showed that these molecules discriminated Allograft rejections from WFG. CONCLUSION Quantification of TIM-3 and KIM-1 mRNA expressions, along with KIM-1 protein measurements in urine and blood could be employed as promising tools for noninvasive diagnosis of allograft dysfunction.
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146
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Urinary biomarkers in the early detection and follow-up of tubular injury in childhood urolithiasis. Clin Exp Nephrol 2017; 22:133-141. [PMID: 28653226 DOI: 10.1007/s10157-017-1436-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/21/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND To investigate relationships among urinary biomarkers [kidney injury molecule-1 (KIM-1), N-acetyl-β-glucosaminidase (NAG)], neutrophil gelatinase-associated lipocalin (NGAL) levels and renal tubular injury in childhood urolithiasis. METHODS Seventy children [36 girls, mean age: 7.3 ± 5.0 years (0.5-18.2)] with urolithiasis/microlithiasis and 42 controls [18 girls, mean age: 8.5 ± 3.8 years (0.9-16.2)] were included in this multicenter, controlled, prospective cohort study. Patients were evaluated three times in 6-month intervals (0, 6 and 12th months). Anthropometric data, urinary symptoms, family history and diagnostic studies were recorded. Urine samples were analyzed for metabolic risk factors (urinary calcium, uric acid, oxalate, citrate, cystine, magnesium, and creatinine excretion), and the urinary KIM-1, NAG, and NGAL levels were measured. RESULTS Stones were mostly located in the upper urinary system (82.9%), and six patients (8.6%) had hydronephrosis. Thirty patients (42.9%) had several metabolic risk factors, and the most common metabolic risk factor was hypocitraturia (22.9%). Urinary KIM-1/Cr, NAG/Cr and NGAL/Cr ratios were not significantly different between patients and controls. Furthermore, no significant changes in their excretion were shown during follow-up. Notably, the urinary KIM-1/Cr, NAG/Cr, and NGAL/Cr levels were significantly higher in children under 2 years of age (p = 0.011, p = 0.006, and 0.015, respectively). NAG/Cr and NGAL/Cr ratios were significantly increased in patients with hydronephrosis (n = 6, p = 0.031 and 0.023, respectively). CONCLUSIONS The results of this study suggest that none of the aforementioned urinary biomarkers (KIM-1, NAG and NGAL levels) may be useful for the early detection and/or follow-up of renal tubular injury and/or dysfunction in childhood urolithiasis.
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147
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Campion CG, Sanchez-Ferras O, Batchu SN. Potential Role of Serum and Urinary Biomarkers in Diagnosis and Prognosis of Diabetic Nephropathy. Can J Kidney Health Dis 2017; 4:2054358117705371. [PMID: 28616250 PMCID: PMC5461910 DOI: 10.1177/2054358117705371] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 02/17/2017] [Indexed: 12/11/2022] Open
Abstract
PURPOSE OF REVIEW Diabetic nephropathy (DN) is a progressive kidney disease caused by alterations in kidney architecture and function, and constitutes one of the leading causes of end-stage renal disease (ESRD). The purpose of this review is to summarize the state of the art of the DN-biomarker field with a focus on the new strategies that enhance the sensitivity of biomarkers to predict patients who will develop DN or are at risk of progressing to ESRD. OBJECTIVE In this review, we provide a description of the pathophysiology of DN and propose a panel of novel putative biomarkers associated with DN pathophysiology that have been increasingly investigated for diagnosis, to predict disease progression or to provide efficient personal treatment. METHODS We performed a review of the literature with PubMed and Google Scholar to collect baseline data about the pathophysiology of DN and biomarkers associated. We focused our research on new and emerging biomarkers of DN. KEY FINDINGS In this review, we summarized the critical signaling pathways and biological processes involved in DN and highlighted the pathogenic mediators of this disease. We next proposed a large review of the major advances that have been made in identifying new biomarkers which are more sensitive and reliable compared with currently used biomarkers. This includes information about emergent biomarkers such as functional noncoding RNAs, microRNAs, long noncoding RNAs, exosomes, and microparticles. LIMITATIONS Despite intensive strategies and constant investigation, no current single treatment has been able to reverse or at least mitigate the progression of DN, or reduce the morbidity and mortality associated with this disease. Major difficulties probably come from the renal disease being heterogeneous among the patients. IMPLICATIONS Expanding the proteomics screening, including oxidative stress and inflammatory markers, along with metabolomics approaches may further improve the prognostic value and help in identifying the patients with diabetes who are at high risk of developing kidney diseases.
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Affiliation(s)
- Carole G. Campion
- Centre de recherche, Centre Hospitalier de l’Université de Montréal (CRCHUM), Québec, Canada
| | - Oraly Sanchez-Ferras
- Department of Biochemistry, Goodman Cancer Research Centre, McGill University, Montreal, Québec, Canada
| | - Sri N. Batchu
- St. Michael’s Hospital, University of Toronto, Ontario, Canada
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148
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Park M, Hsu CY, Go AS, Feldman HI, Xie D, Zhang X, Mifflin T, Waikar SS, Sabbisetti VS, Bonventre JV, Coresh J, Nelson RG, Kimmel PL, Kusek JW, Rahman M, Schelling JR, Vasan RS, Liu KD. Urine Kidney Injury Biomarkers and Risks of Cardiovascular Disease Events and All-Cause Death: The CRIC Study. Clin J Am Soc Nephrol 2017; 12:761-771. [PMID: 28254771 PMCID: PMC5477212 DOI: 10.2215/cjn.08560816] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/19/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES CKD is an important risk factor for cardiovascular disease (CVD) and death. We investigated whether select urine kidney injury biomarkers were associated with higher risk of heart failure (HF), CVD, and death in persons with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Urine kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, and N-acetyl-β-d-glucosaminidase were measured in urine of a subset of CRIC participants (n=2466). We used Cox proportional hazards regression to examine associations between these biomarkers indexed to urinary creatinine (Cr) and (1) HF, (2) a composite of atherosclerotic CVD events (myocardial infarction, ischemic stroke, or peripheral artery disease), and (3) all-cause death. RESULTS At baseline, mean age of study participants was 59.5±10.8 years, 46% were women, and 34% had a self-reported history of any CVD. Median follow-up was 6.5 (interquartile range, 5.6-6.8) years. A total of 333 HF events, 282 atherosclerotic CVD events, and 440 deaths were observed during a median follow-up of 6.5 (interquartile range, 5.6-6.8) years. Those in the highest two quintiles of KIM-1/Cr levels had a higher risk of HF relative to the lowest quintile (quintile 5 versus quintile 1 adjusted hazard ratio [aHR] of 1.73 [95% confidence interval, 1.05 to 2.85]). N-acetyl-β-d-glucosaminidase/Cr was associated with HF in continuous analyses (aHR per log SD higher 1.18 [95% confidence interval, 1.01 to 1.38]). Only KIM-1/Cr was independently associated with atherosclerotic CVD events (aHR per log SD higher 1.21 [95% confidence interval, 1.02 to 1.41]), whereas both KIM-1/Cr (quintile 5 versus quintile 1 aHR of 1.56 [95% confidence interval, 1.06 to 2.31]) and neutrophil gelatinase-associated lipocalin/Cr (quintile 5 versus quintile 1 aHR of 1.82 [95% confidence interval, 1.19 to 2.8]) were associated with all-cause death. CONCLUSIONS Selected urine kidney injury biomarkers were independently associated with higher risk of HF, CVD events, and death in CRIC. Among the biomarkers examined, only KIM-1/Cr was associated with each outcome. Further work is needed to determine the utility of these biomarkers to improve risk prediction for these adverse outcomes.
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Affiliation(s)
- Meyeon Park
- Division of Nephrology, University of California, San Francisco, San Francisco, California
| | - Chi-yuan Hsu
- Division of Nephrology, University of California, San Francisco, San Francisco, California
| | - Alan S. Go
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Harold I. Feldman
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Dawei Xie
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Xiaoming Zhang
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Theodore Mifflin
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sushrut S. Waikar
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Joseph V. Bonventre
- Division of Renal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Robert G. Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Paul L. Kimmel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - John W. Kusek
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, Ohio; and
| | - Jeffrey R. Schelling
- Division of Nephrology and Hypertension, Case Western Reserve University, Cleveland, Ohio; and
| | - Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Boston University, Boston, Massachusetts
| | - Kathleen D. Liu
- Division of Nephrology, University of California, San Francisco, San Francisco, California
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149
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Silva SCT, de Almeida LA, Soares S, Grossi MF, Valente AMS, Tagliati CA. In vitro study of putative genomic biomarkers of nephrotoxicity through differential gene expression using gentamicin. Toxicol Mech Methods 2017; 27:435-441. [PMID: 28372472 DOI: 10.1080/15376516.2017.1313345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Drug-induced nephrotoxicity is one of the most frequently observed effects in long-term pharmacotherapy. The effects of nephrotoxicity are commonly discovered later due to a lack of sensitivity in in vivo methods. Therefore, researchers have tried to develop in vitro alternative methods for early identification of toxicity. In this study, LLC-PK1 cells were exposed to gentamicin through MTT and trypan blue assay. Concentrations of 4 (low), 8 (medium) and 12 (high) mM, were used to evaluate differential gene expression. A panel of genes was selected based on gene expression changes. The search for sequences of mRNA encoding proteins previously associated with kidney damage was conducted in the databases of the National Center for Biotechnology Information (USA). RNA was extracted from the cells, and RT-qPCR was performed to evaluate differential expression profiles of the selected genes. Among the 11 analyzed genes, four proved to be differentially up-regulated in cells exposed to gentamicin: HAVcr1, caspase 3, ICAM-1 and EXOC6. According to this study's results, we suggest that these genes play an important role in the mechanism of in vitro nephrotoxicity caused by gentamicin and can be used as early in vitro biomarkers to identify nephrotoxicity when developing safer drugs.
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Affiliation(s)
- Sarah Cristina Teixeira Silva
- a Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Laboratório de Toxicologia Experimental in vitro , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
| | - Leonardo Augusto de Almeida
- b Departamento de Microbiologia e Imunologia, Laboratório de Imunologia, Instituto de Ciências Biomédicas , Universidade Federal de Alfenas (UniFal) , Alfenas , Brazil
| | - Stellamaris Soares
- a Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Laboratório de Toxicologia Experimental in vitro , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
| | - Marina Felipe Grossi
- a Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Laboratório de Toxicologia Experimental in vitro , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
| | - Anete Maria Santana Valente
- c Departamento de Nutrição , Universidade Federal de Juiz de Fora (UFJF) - Campus Governador Valadares , Governador Valadares , Brazil
| | - Carlos Alberto Tagliati
- a Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Laboratório de Toxicologia Experimental in vitro , Universidade Federal de Minas Gerais (UFMG) , Belo Horizonte , Brazil
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150
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Mohamed F, Buckley NA, Pickering JW, Wunnapuk K, Dissanayake S, Chathuranga U, Gawarammana I, Jayamanne S, Endre ZH. Nephrotoxicity-induced proteinuria increases biomarker diagnostic thresholds in acute kidney injury. BMC Nephrol 2017; 18:122. [PMID: 28372541 PMCID: PMC5379711 DOI: 10.1186/s12882-017-0532-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/24/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Paraquat ingestion is frequently fatal. While biomarkers of kidney damage increase during paraquat-induced acute kidney injury (AKI), significant concurrent proteinuria may alter diagnostic thresholds for diagnosis and prognosis to an unknown extent. This study evaluated the effect of albuminuria on biomarker cutoffs for diagnosis and outcome prediction. METHODS This was a multi-centre prospective clinical study of patients following acute paraquat self-poisoning in 5 Sri Lankan hospitals. Biomarker concentrations were quantified using ELISA and microbead assays and correlated with urinary albumin. Functional-AKI was defined by the Acute Kidney Injury Network serum creatinine definition and alternatively by a ≥50% increase in serum cystatin C. Albuminuria was defined as albumin-creatinine ratio >30 mg/g. The study outcomes were compared with a retrospective analysis of a pre-clinical study of paraquat-induced nephrotoxicity with appropriate controls. RESULTS Albuminuria was detected in 34 of 50 patients, and increased with functional-AKI severity. The concentrations of uNGAL, uCysC, uClusterin, uβ2M, and uKIM-1 were higher in albuminuric compared to non-albuminuric patients (p < 0.001). Albuminuria correlated with biomarker concentration (r > 0.6, p < 0.01) and was associated with death (p = 0.006). Optimal biomarker cutoffs for prediction of death were higher in the albuminuric group. Similar outcomes with more detailed analysis were obtained in experimental paraquat nephrotoxicity. CONCLUSION Albuminuria was associated with paraquat-induced nephrotoxicity and increased excretion of low-molecular weight protein biomarkers. AKI biomarker cutoffs for diagnosis, outcome prediction and AKI stratification increased in the presence of albuminuria. This may lead to over-diagnosis of AKI in conditions independently associated with proteinuria.
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Affiliation(s)
- Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka. .,Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka. .,Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia. .,TACT Research Group, Department of Pharmacology, SOMS, Sydney Medical School, University of Sydney NSW, Sydney, Australia. .,SACTRC, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
| | - Nicholas A Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,TACT Research Group, Department of Pharmacology, SOMS, Sydney Medical School, University of Sydney NSW, Sydney, Australia
| | - John W Pickering
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.,Emergency Department, Christchurch Hospital, Christchurch, New Zealand
| | - Klintean Wunnapuk
- Department of Forensic Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sandamali Dissanayake
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Umesh Chathuranga
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Indika Gawarammana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Shaluka Jayamanne
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Zoltan H Endre
- Department of Nephrology, Prince Of Wales Hospital and Clinical School, University of New South Wales, Sydney, Australia.,Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
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