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Gupta R, Paul K. A fluorescent "Turn-ON" probe with rapid and differential response to HSA and BSA: quantitative detection of HSA in urine. J Mater Chem B 2024. [PMID: 39158475 DOI: 10.1039/d4tb00749b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024]
Abstract
The present study provides insight into the differential response of a benzimidazole-malononitrile fluorescent "Turn-ON" probe on interaction with two structurally similar proteins, BSA and HSA. Compound 6 shows more sensitivity towards the two SAs, which is completely lost in the case of compound 7, synthesized by substitution on 6. The aggregates of compound 6 show absorption maxima at 385 nm and weak emission maxima at 565 nm. Compound 6 forms a new emission band at 475 nm on gradual addition of BSA (200 μM) along with a slight increase in the emission band at 565 nm. However, on addition of HSA (50 μM), a new band at 475 nm is formed. In contrast to BSA, in the case of HSA, 50% quenching is observed in the emission band of compound 6 at 565 nm. The new band formed on the interaction of 6 with BSA shows four-fold more enhancement compared to HSA. Furthermore, the mechanism of interaction of 6 with serum albumin has been investigated through lifetime-fluorescence analysis, site-selective drug experiments, dynamic light scattering, FE-SEM, FT-IR, etc. Molecular docking studies and site marker drug displacement experiments reveal differential interactions of 6 towards the two structurally similar proteins. Aggregates of 6 with an average hydrodynamic size of 100-190 nm are disassembled on adding BSA and HSA, and the size of the serum albumin and 6 complex decreases to 10-20 nm, revealing the ligand's encapsulation in the serum albumin cavity. Practical applicability for the quantitative detection of HSA in human urine samples is also demonstrated. The high binding affinity, sensitivity, selectivity and differential response of probe 6 towards two serum albumins (HSA and BSA) and significant quantification of HSA in urine samples shows the potential ability of this probe in medical applications.
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Affiliation(s)
- Rohini Gupta
- Department of Chemistry and Biochemistry, Thapar Institute of Engineering and Technology, Patiala-147001, India.
| | - Kamaldeep Paul
- Department of Chemistry and Biochemistry, Thapar Institute of Engineering and Technology, Patiala-147001, India.
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Patel S, Sathyanathan V, Salaman SD. Molecular mechanisms underlying cisplatin-induced nephrotoxicity and the potential ameliorative effects of essential oils: A comprehensive review. Tissue Cell 2024; 88:102377. [PMID: 38626527 DOI: 10.1016/j.tice.2024.102377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/18/2024]
Abstract
Since the Middle Ages, essential oils (EO) have been widely used for bactericidal, virucidal, fungicidal, insecticidal, medicinal and cosmetic applications, nowadays in pharmaceutical, agricultural and food industries. Recently, EO have emerged as promising adjuvant therapies to mitigate the toxicities induced by anti - cancerous drugs; among them cisplatin induced renal damage amelioration remain remarkable. Cisplatin (cis-diaminedichloroplatinum II, CDDP) is renowned as one of the most effective anti-neoplastic agents, widely used as a broad-spectrum anti-tumor agent for various solid tumors. However, its clinical use is hampered by several side effects, notably nephrotoxicity and acute kidney injury, which arise from the accumulation of CDDP in the proximal tubular epithelial cells (PTECs). To better understand and analyze the molecular mechanisms of CDDP-induced renal damage, it is crucial to investigate potential interventions to protect against cisplatin-mediated nephrotoxicity. These EO have shown the ability to counteract oxidative stress, reduce inflammation, prevent apoptosis, and exert estrogenic effects, all contributing to renal protection. In this review, we have made an effort to summarize the molecular mechanisms and exploring new interventions by which we can pave the way for safer and more effective cancer management in the future.
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Affiliation(s)
- Saraswati Patel
- Department of Pharmacology, Saveetha College of Pharmacy, Saveetha Institute of Medical and Technical Sciences, Chennai, India.
| | - V Sathyanathan
- Department of Pharmacognosy, Apollo College of Pharmacy, Kanchipuram, Tamil Nadu, India
| | - Samsi D Salaman
- Department of Pharmacognosy, Apollo College of Pharmacy, Kanchipuram, Tamil Nadu, India
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Liu W, Su ZH, Wan QJ. Proteinuria selectivity index in renal disease. Clin Chim Acta 2024; 552:117675. [PMID: 38007057 DOI: 10.1016/j.cca.2023.117675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023]
Abstract
One of the main barriers to early detection and subsequent prevention of kidney diseases is the accessibility and feasibility of testing, especially in urine research. The proteinuria selectivity index (PSI or SI) is a method used to assess changes in glomerular permeability in glomerular diseases. It describes the pattern of proteinuria by comparing the clearance rates of large molecular proteins and transferrin, categorizing it as selective or non-selective. PSI is widely applied for kidney disease classification, prediction of corticosteroid efficacy, and prognosis. Herein, we reviewed the clinical applications and recent advancements of PSI in glomerular diseases, compared it with commonly used renal function biomarkers, and discussed the future research directions for PSI as a potential predictive marker for response to specific biologics.
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Affiliation(s)
- Wen Liu
- Department of Nephrology, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen 518036, China
| | - Zhi-Hang Su
- Department of Nephrology, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen 518036, China
| | - Qi-Jun Wan
- Department of Nephrology, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People's Hospital), Shenzhen 518036, China.
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Karrar S, Fogel J, Hong P. Withstanding the test of time: Morning versus afternoon/evening urine protein-to-creatinine ratios in preeclampsia. Pregnancy Hypertens 2023; 34:90-94. [PMID: 37866299 DOI: 10.1016/j.preghy.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/04/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE There are mixed findings regarding time preference for measuring spot urine protein to creatinine ratios (UPCR) in renal patients but no such literature among pregnant patients. We compare AM versus PM measurements for UPCR among pregnant patients with preeclampsia. STUDY DESIGN This retrospective study included 163 patients diagnosed with preeclampsia. Laboratory tests of UPCR, urine specificity gravity, and uric acid were collected for these patients during the morning (AM) 12:00 AM (00:00) through 11:59 AM (11:59) and afternoon/evening (PM) 12:00 PM (12:00) through 11:59 PM (23:59). MAIN OUTCOME MEASURES Outcomes were UPCR percentages indicative of preeclampsia, UPCR median values, abnormal uric acid, and normal urine specific gravity indicative of a quality sample for measuring UPCR. RESULTS UPCR ≥ 0.3 indicative of preeclampsia significantly differed (p < 0.001) where the AM group (76.7 %) had a greater percentage than the PM group (52.8 %). Median UPCR significantly differed (p < 0.001) where the AM group had a greater median (0.44) than the PM group (0.32). None of the uric acid or urine specific gravity comparisons significantly differed between the AM and PM groups. Similar patterns occurred for subgroups of those with hypertension, nulliparous, and preeclampsia with severe features. CONCLUSION We found that UPCR had greater median values and more values indicative of preeclampsia for AM measurements than PM measurements. Clinicians who use spot urine measurements and not 24-hour urine measurements should preferably measure UPCR in the AM rather than the PM.
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Affiliation(s)
- Shahd Karrar
- Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY, USA
| | - Joshua Fogel
- Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY, USA; Department of Business Management, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Peter Hong
- Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY, USA.
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Mitsides N, Mitra V, Saha A, Harris S, Kalra PA, Mitra S. Urinary Liver-Type Fatty Acid Binding Protein, a Biomarker for Disease Progression, Dialysis and Overall Mortality in Chronic Kidney Disease. J Pers Med 2023; 13:1481. [PMID: 37888092 PMCID: PMC10608048 DOI: 10.3390/jpm13101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/01/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Chronic kidney disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid binding protein (uL-FABP) may be a suitable biomarker for CKD progression and can add value to currently established biomarkers such as the urinary protein-to-creatinine ratio (uPCR). A total of 583 participants with CKD 1-5 (not receiving renal replacement therapy) entered a 2 yr prospective longitudinal study. UPCR and uL-FABP were measured at baseline and CKD progression was defined as either (i) a decline in eGFR of >5 mL/min/1.73 m2 or an increase in serum creatinine by 10% at 1 yr; (ii) a decline in eGFR of >6 mL/min/1.73 m2 or an increase in serum creatinine by 20% at 2 yrs; or (iii) the initiation of RRT. A combined outcome of initiating RRT or death was also included. Approximately 40% of participants showed CKD progression. uL-FABP predicted CKD progression at both years 1 and 2 (OR 1.01, p < 0.01). Sensitivity and specificity were comparable to those of uPCR (AUC 0.623 v 0.706) and heat map analysis suggested that uL-FABP in the absence of significant proteinuria can predict an increase in serum creatinine of 10% at 1 yr and 20% at 2 yrs. The risk of the combined outcome of initiating RRT or death was 23% higher in those with high uL-FABP (p < 0.01) independent of uPCR. uL-FABP appears to be a highly sensitive and specific biomarker of CKD progression. The use of this biomarker could enhance the risk stratification of CKD and its progression and should be assessed further.
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Affiliation(s)
- Nicos Mitsides
- Medical School, University of Cyprus, 2029 Nicosia, Cyprus
- Department of Nephrology, Nicosia General Hospital, 2029 Nicosia, Cyprus
| | - Vikram Mitra
- John Radcliffe Hospital, Oxford University Medical School, Headington, University of Oxford, Oxford OX1 2JD, UK;
| | - Ananya Saha
- Manchester Institute of Nephrology and Transplantation, Department of Research and Innovation, Manchester University Hospitals, Manchester M13 9WL, UK; (A.S.); (S.H.)
| | - Shelly Harris
- Manchester Institute of Nephrology and Transplantation, Department of Research and Innovation, Manchester University Hospitals, Manchester M13 9WL, UK; (A.S.); (S.H.)
| | - Philip A. Kalra
- Department of Renal Medicine, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Sciences Centre, Salford M6 8HD, UK;
| | - Sandip Mitra
- Manchester Institute of Nephrology and Transplantation, Manchester University Hospitals & University of Manchester, Manchester Academic Health Sciences Centre, Manchester M13 9WL, UK
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Pinrod V, Chawjiraphan W, Segkhoonthod K, Hanchaisri K, Tantiwathanapong P, Pinpradup P, Putnin T, Pimalai D, Treerattrakoon K, Cha’on U, Anutrakulchai S, Japrung D. Development of a High-Accuracy, Low-Cost, and Portable Fluorometer with Smartphone Application for the Detection of Urinary Albumin towards the Early Screening of Chronic Kidney and Renal Diseases. BIOSENSORS 2023; 13:876. [PMID: 37754110 PMCID: PMC10526137 DOI: 10.3390/bios13090876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023]
Abstract
This study presents the development of a portable fluorometer with a smartphone application designed to facilitate the early screening of chronic kidney and renal diseases by enabling the sensitive detection of urinary albumin. Utilizing a fluorescence-based aptasensor, the device achieved a linear calibration curve (0.001-1.5 mg/mL) with a linearity of up to 0.98022 and a detection limit of 0.203 µg/mL for human serum albumin (HSA). The analysis of 130 urine samples demonstrated comparable performance between this study's fluorometer, a commercial fluorometer, and the standard automated method. These findings validate the feasibility of the portable fluorometer and aptasensor combination as a reliable instrument for the sensitive and specific measurement of HSA in urine samples. Moreover, the fluorometer's portability offers potential applications in portable point-of-care testing, enhancing its utility in clinical settings for early disease screening.
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Affiliation(s)
- Visarute Pinrod
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Wireeya Chawjiraphan
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Khoonsake Segkhoonthod
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Kriangkai Hanchaisri
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Phornpol Tantiwathanapong
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Preedee Pinpradup
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Thitirat Putnin
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Dechnarong Pimalai
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
| | - Kiatnida Treerattrakoon
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
- Department of Pure and Applied Chemistry, Technology and Innovation Centre, University of Strathclyde, Glasgow G1 1RD, UK
| | - Ubon Cha’on
- Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Sirirat Anutrakulchai
- Chronic Kidney Disease Prevention in the Northeast of Thailand (CKDNET), Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Deanpen Japrung
- National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Thailand Science Park, Pathumthani 12120, Thailand; (V.P.); (W.C.); (K.S.); (K.H.); (P.P.); (T.P.); (D.P.); (K.T.)
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Pereira MAM, Jordan RFR, de Matos JPS, Carraro-Eduardo JC. Albumin-to-protein ratio in spot urine samples for analysis of proteinuria selectivity in chronic kidney disease. J Bras Nefrol 2023; 45:252-256. [PMID: 36200855 PMCID: PMC10627120 DOI: 10.1590/2175-8239-jbn-2022-0079en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/04/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The albumin-to-creatinine ratio and total protein-to-creatinine ratio in spot urine samples have already been validated as surrogates for 24-hour albuminuria and proteinuria measurements. Thus, we hypothesized that the type of proteinuria, detected by the electrophoretic pattern of 24-hour urine, could be predicted by the simple proportion of albumin in the total urine protein content, using the albumin-to-protein ratio (APR). Our study sought to validate the use of APR as a cheaper substitute for urinary protein electrophoresis (UPE). METHODS Using different mathematical models, we compared, the albumin fraction in 24-hour urine samples by electrophoresis and the APR ratio in spot samples from 42 outpatients with chronic kidney disease (CKD). RESULTS A strong log-order correlation r = 0.84 (0.75-0.92; 95% CI, p = 0.001) was observed between APR and the albumin fraction in the UPE. CONCLUSION The APR can substitute electrophoresis in CKD outpatients.
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Zhuang Z, Tong M, Clarke R, Wang B, Huang T, Li L. Probability of chronic kidney disease and associated risk factors in Chinese adults: a cross-sectional study of 9 million Chinese adults in the Meinian Onehealth screening survey. Clin Kidney J 2022; 15:2228-2236. [PMID: 36381363 PMCID: PMC9664583 DOI: 10.1093/ckj/sfac176] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Chronic kidney disease (CKD) is an increasing global health problem, but little is known about the age- and sex-specific prevalence of CKD and the associated risk factors in low- and middle-income populations. We examined the age- and sex-specific prevalence of CKD and the associated risk factors in a population-based study of 9 million Chinese adults. Methods The study involved a cross-sectional survey of 9 461 631 adults, >18 years of age, who were recruited in 2017 from 31 provinces in the Meinian Onehealth screening survey. All participants had plasma creatinine measured by standard methods and CKD was defined if the estimated glomerular filtration rate (eGFR) was <60 ml/min/1.73 m2. Results Overall, among 9.5 million adults [mean age 41 years (standard deviation 13.1)], 88 271 (1.26%) had CKD. The prevalence rate of CKD was 1.20%, 0.04% and 0.02% for stage 3, 4 and 5, respectively. After adjustment for the proportion and prevalence of urban and rural areas, the overall prevalence rate of CKD was 1.07%, indicating that ∼14 million Chinese adults have CKD. The prevalence of CKD increased 3-fold for each 10-year increment in age (1.15%, 3.05% and 13.02% at age 50-59, 60-69 and >70 years, respectively) and was 1.8-fold higher in women than men. The prevalence of CKD was higher in the Southwest region {1.68% [95% confidence interval (CI) 1.12-2.24]} but lower in the Northwest region [0.84% (95% CI 0.61-1.07)] than other regions. If proteinuria is also used as a diagnostic criterion, the prevalence rate increased to 2.16%. Stepwise logistic regression analysis demonstrated that body mass index; history of hypertension, cardiovascular disease or diabetes; and levels of systolic blood pressure, triglycerides, fasting glucose and uric acid were independent risk factors for CKD. Conclusion CKD is an important public health problem in Chinese adults and this study highlights the need for public health strategies to detect and reduce modifiable risk factors for prevention of CKD.
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Affiliation(s)
- Zhenhuang Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Mingkun Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Bo Wang
- Correspondence to: Bo Wang; E-mail:
| | - Tao Huang
- Correspondence to: Tao Huang; E-mail:
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
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Pereira MAM, Jordan RFR, Matos JPSD, Carraro-Eduardo JC. Razão albumina/proteína em amostras isoladas de urina para análise da seletividade de proteinúria na doença renal crônica. J Bras Nefrol 2022. [DOI: 10.1590/2175-8239-jbn-2022-0079pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução: A utilização da razão albumina/creatinina e da razão proteína total/creatinina em amostras isoladas de urina já foram validadas como substitutos para a albuminúria e proteinúria em 24 horas. Assim, nossa hipótese é que o tipo de proteinúria, dado pelo padrão eletroforético da urina de 24 horas, poderia ser previsto pela simples proporção de albumina no conteúdo total de proteínas na urina, utilizando a razão albumina/proteína (RAP). O presente estudo procurou validar o uso da RAP como um substituto mais prático e de menor custo da eletroforese de proteínas urinárias (EPU). Métodos: Foram utilizados diferentes modelos matemáticos a fim de comparar a fração de albumina pela eletroforese em amostras de urina de 24 horas e a RAP em amostras isoladas em 42 pacientes ambulatoriais com doença renal crônica. Resultados: Foi observada uma forte correlação logarítmica r = 0,84 (0,75–0,92; 95% CI, p = 0,001) entre a RAP e a fração de albumina pela EPU. Conclusão: A RAP pode substituir a eletroforese urinária em pacientes renais crônicos ambulatoriais.
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Roehm B, McAdams M, Hedayati SS. Novel Biomarkers of Kidney Disease in Advanced Heart Failure: Beyond GFR and Proteinuria. Curr Heart Fail Rep 2022; 19:223-235. [PMID: 35624386 DOI: 10.1007/s11897-022-00557-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Kidney disease is a common finding in patients with heart failure and can significantly impact treatment decisions and outcomes. Abnormal kidney function is currently determined in clinical practice using filtration markers in the blood to estimate glomerular filtration rate, but the manifestations of kidney disease in the setting of heart failure are much more complex than this. In this manuscript, we review novel biomarkers that may provide a more well-rounded assessment of kidney disease in patients with heart failure. RECENT FINDINGS Galectin-3, ST2, FGF-23, suPAR, miRNA, GDF-15, and NAG may be prognostic of kidney disease progression. L-FABP and suPAR may help predict acute kidney injury (AKI). ST2 and NAG may be helpful in diuretic resistance. Several biomarkers may be useful in determining prognosis of long-term kidney disease progression, prediction of AKI, and development of diuretic resistance. Further research into the mechanisms of kidney disease in heart failure utilizing many of these biomarkers may lead to the identification of therapeutic targets.
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Affiliation(s)
- Bethany Roehm
- Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6201 Harry Hines Boulevard, Dallas, TX, 75390, USA.
| | - Meredith McAdams
- Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6201 Harry Hines Boulevard, Dallas, TX, 75390, USA
| | - S Susan Hedayati
- Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 6201 Harry Hines Boulevard, Dallas, TX, 75390, USA
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A 90-Day Safety Study of Meat from MSTN and FGF5 Double-Knockout Sheep in Wistar Rats. Life (Basel) 2022; 12:life12020204. [PMID: 35207492 PMCID: PMC8880117 DOI: 10.3390/life12020204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
MSTN and FGF5 gene knockout sheep generated by the CRISPR/Cas9 system exhibit the ‘double-muscle’ phenotype, and increased density and length of hairs, providing valuable new breeding material. In a previous study, we obtained MSTN and FGF5 double-knockout sheep of significant breeding value. In this study, we carried out a 90-day feeding study in Wistar rats to assess the safety of genome-edited mutton. Seven rat groups with 10 females and 10 males per group were fed different concentrations (3.75%, 7.5%, and 15%) of double-knockout mutton or wild-type mutton in a conventional commercial diet for 90 days. At the end of the feeding, routine urine and blood tests and measurements of blood biochemical indicators were performed. Furthermore, the major organs of each group of rats were weighed and examined histopathologically. Although there were significant differences among the groups in some parameters, all values were within the normal ranges. Therefore, the 90-day rat feeding study showed that the meat from MSTN and FGF5 double-knockout sheep did not have any long-term adverse effects on rat health. This study also provides valuable reference information for assessing the safety of meat from animals with knockout of multiple genes.
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Harkin C, Cobice D, Brockbank S, Bolton S, Johnston F, Strzelecka A, Watt J, Kurth MJ, Lamont JV, Fitzgerald P, Moore T, Ruddock MW. Biomarkers for Detecting Kidney Dysfunction in Type-2 Diabetics and Diabetic Nephropathy Subjects: A Case-Control Study to Identify Potential Biomarkers of DN to Stratify Risk of Progression in T2D Patients. Front Endocrinol (Lausanne) 2022; 13:887237. [PMID: 35846341 PMCID: PMC9276980 DOI: 10.3389/fendo.2022.887237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Currently there are no biomarkers that are predictive of when patients with type-2 diabetes (T2D) will progress to more serious kidney disease i.e., diabetic nephropathy (DN). Biomarkers that could identify patients at risk of progression would allow earlier, more aggressive treatment intervention and management, reducing patient morbidity and mortality. MATERIALS AND METHODS Study participants (N=88; control n=26; T2D n=32; DN n=30) were recruited from the renal unit at Antrim Area Hospital, Antrim, UK; Whiteabbey Hospital Diabetic Clinic, Newtownabbey, UK; Ulster University (UU), Belfast, UK; and the University of the Third Age (U3A), Belfast, UK; between 2019 and 2020. Venous blood and urine were collected with a detailed clinical history for each study participant. RESULTS In total, 13/25 (52.0%) biomarkers measured in urine and 25/34 (73.5%) biomarkers measured in serum were identified as significantly different between control, T2D and DN participants. DN patients, were older, smoked more, had higher systolic blood pressure and higher serum creatinine levels and lower eGFR function. Serum biomarkers significantly inversely correlated with eGFR. CONCLUSION This pilot-study identified several serum biomarkers that could be used to predict progression of T2D to more serious kidney disease: namely, midkine, sTNFR1 and 2, H-FABP and Cystatin C. Our results warrant confirmation in a longitudinal study using a larger patient cohort.
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Affiliation(s)
- Carla Harkin
- Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Diego Cobice
- Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Simon Brockbank
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
| | | | | | - Anna Strzelecka
- Diabetes Clinic, Whiteabbey Hospital, Newtownabbey, United Kingdom
| | - Joanne Watt
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
| | - Mary Jo Kurth
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
| | - John V. Lamont
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
| | - Peter Fitzgerald
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
| | - Tara Moore
- Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Mark W. Ruddock
- Randox Laboratories Ltd, Clinical Studies Group, Randox Science Park, Antrim, United Kingdom
- *Correspondence: Mark W. Ruddock,
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13
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Abdou AE, Anani HAA, Ibrahim HF, Ebrahem EE, Seliem N, Youssef EMI, Ghoraba NM, Hassan AS, Ramadan MAA, Mahmoud E, Issa S, Maghraby HM, Abdelrahman EK, Hassan HAM. Urinary IgG, serum CX3CL1 and miRNA-152-3p: as predictors of nephropathy in Egyptian type 2 diabetic patients. Tissue Barriers 2021; 10:1994823. [PMID: 34689723 DOI: 10.1080/21688370.2021.1994823] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The purpose of this study was to assess the role of urinary IgG, serum CX3CL1 and miRNA 152-3p levels as predictors of nephropathy in type 2 Egyptian diabetic patients. Sixty type 2 diabetic patients and twenty healthy controls were enrolled in a cross-sectional study. Then they were grouped into: three groups based upon urine albumin excretion (UAE). The expression of miRNA 152-3p in serum was measured using quantitative polymerase chain reaction (RTq-PCR). Serum CX3CL1 and urinary IgG concentrations were measured by ELISA. RTq-PCR revealed that serum miRNA-152-3p levels in patients were significantly higher than in controls. There was significant differences between group with normoalbuminuria and groups with diabetic nephropathy DN as regard to age, duration of nephropathy, Albumin/Creatinine ratio (A/C ratio), creatinine, urine IgG, CX3CL1 and HbA1c. In diabetic patients, there was a significant positive correlation between miRNA-152-3p levels and disease duration only as well as significant positive correlations between urinary IgG levels and age, disease duration, serum creatinine, A/C ratio, and urea. Positive correlation between serum fractalkine CX3CL1 level and age, duration of disease, urea, creatinine, A/C ratio, HbA1C and IgG in patient with DN. Serum CX3CL1 level, urinary IgG were significantly increased with the progress of nephropathy so these integrated biomarkers could be used as good predictors for early identification of nephropathy. But miRNA- 152-3p has inadequate prognostic indicator for ESRD progression.
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Affiliation(s)
- Aml E Abdou
- Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Haneya A A Anani
- Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Hanan F Ibrahim
- Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Elshohat Ebrahem
- Biochemistry Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nora Seliem
- Biochemistry Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman M I Youssef
- Biochemistry Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.,Biochemistry Department, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Niveen M Ghoraba
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Asmaa S Hassan
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Marwa A A Ramadan
- Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman Mahmoud
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Shorouk Issa
- Department of Endocrinology and Metabolism, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Hend M Maghraby
- Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Eman K Abdelrahman
- Internal Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt
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14
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Flammia RS, Tufano A, Proietti F, Gerolimetto C, DE Nunzio C, Franco G, Leonardo C. Renal surgery for kidney cancer: is preoperative proteinuria a predictor of functional and survival outcomes after surgery? A systematic review of the literature. Minerva Urol Nephrol 2021; 74:255-264. [PMID: 34156198 DOI: 10.23736/s2724-6051.21.04308-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Proteinuria is considered both a known marker for the severity of Chronic Kidney Disease (CKD) and a robust predictor of future renal function and cardiovascular morbidity and mortality in a general population. The urological community has long overlooked proteinuria as a marker of renal function. Recently, the American Urological Association (AUA) clinical practice guideline addressed this issue and suggested introducing proteinuria assessment prior to kidney cancer surgery. The aim of this systematic review was to provide evidence of proteinuria as a predictor of renal function impairment and survival outcomes after kidney surgery for renal tumors. EVIDENCE ACQUISITION A systematic search was performed by using three search engines (PubMed, Embase®, and Web of Science) from January 2010 to November 2020. Study selection followed the PRISMA guidelines. After screening, ten articles and abstracts fully compatible with the PICOS were included in this systematic review. EVIDENCE SYNTHESIS Overall, a total of 11,705 patients who underwent partial nephrectomy (PN) or radical nephrectomy (RN) were analyzed. When used as a binomial variable, proteinuria prior to surgery was detected from 10% to 33% of patients. Relying on both proteinuria and estimated glomerular filtration rate (eGFR) in the assessment of renal function yielded up to 33% higher rates of patients with preoperative renal impairment. Moreover, proteinuria increased the risk of long-term renal impairment after PN and RN as well as patients with preoperative proteinuria undergoing PN exhibited a greater risk of postoperative acute kidney injury (AKI). Among eligible studies, proteinuria was associated with diabetes, obesity, metabolic syndrome, hypertension and cardiovascular disease. Finally, proteinuria was an independent predictor of overall mortality, but not of cancer-specific mortality. CONCLUSIONS Proteinuria yields a prognostic power beyond that provided by estimated glomerular filtration rate (eGFR) among patients undergoing renal cancer surgery, supporting its introduction in the preoperative assessment of renal function. However, well-designed multicentre prospective studies would be necessary to corroborate these results and provided urological community with high-grade recommendation for clinical practice.
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Affiliation(s)
- Rocco S Flammia
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy -
| | - Antonio Tufano
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Flavia Proietti
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cesare Gerolimetto
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Cosimo DE Nunzio
- UOC Urologia, AOU Sant'Andrea, Sapienza University of Rome, Rome, Italy
| | - Giorgio Franco
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Costantino Leonardo
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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15
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Polydopamine-based quantitation of albuminuria for the assessment of kidney damage. Anal Bioanal Chem 2021; 413:2217-2224. [PMID: 33543313 DOI: 10.1007/s00216-021-03192-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/07/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
Proteinuria is considered indicative of kidney damage that can be related to various adverse outcomes. Nowadays, there is a huge demand for routine urine screening methods to assess health risks in clinical setting without expensive procedures and long pretreatment of the sample. To address this issue, a polydopamine-based colorimetric assay to determine urinary albumin concentration in real samples is proposed here. The core of this approach relies on the established competitive adsorption of polydopamine film and human serum albumin onto the polystyrene surface of ELISA plates. Herein, we investigated the influence of temperature and the Tris-HCl buffer concentration on the polydopamine film growth. The absorbance of polydopamine film, after 24 h at 25 °C, decreases with the increase of HSA concentration, allowing the selective detection of HSA down to 0.036 ± 0.001 g L-1 in untreated urine. This simple and low-cost bioanalytical assay exhibited very good reproducibility, %CVmean = 2 in human urine, and was superior in terms of analytical performances to some standard methods available on the market, especially in comparison to the Bradford assay, for early screening and assessment of kidney damage.
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16
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Aitekenov S, Gaipov A, Bukasov R. Review: Detection and quantification of proteins in human urine. Talanta 2021; 223:121718. [PMID: 33303164 PMCID: PMC7554478 DOI: 10.1016/j.talanta.2020.121718] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 12/31/2022]
Abstract
Extensive medical research showed that patients, with high protein concentration in urine, have various kinds of kidney diseases, referred to as proteinuria. Urinary protein biomarkers are useful for diagnosis of many health conditions - kidney and cardio vascular diseases, cancers, diabetes, infections. This review focuses on the instrumental quantification (electrophoresis, chromatography, immunoassays, mass spectrometry, fluorescence spectroscopy, the infrared spectroscopy, and Raman spectroscopy) of proteins (the most of all albumin) in human urine matrix. Different techniques provide unique information on what constituents of the urine are. Due to complex nature of urine, a separation step by electrophoresis or chromatography are often used for proteomics study of urine. Mass spectrometry is a powerful tool for the discovery and the analysis of biomarkers in urine, however, costs of the analysis are high, especially for quantitative analysis. Immunoassays, which often come with fluorescence detection, are major qualitative and quantitative tools in clinical analysis. While Infrared and Raman spectroscopies do not give extensive information about urine, they could become important tools for the routine clinical diagnostics of kidney problems, due to rapidness and low-cost. Thus, it is important to review all the applicable techniques and methods related to urine analysis. In this review, a brief overview of each technique's principle is introduced. Where applicable, research papers about protein determination in urine are summarized with the main figures of merits, such as the limit of detection, the detectable range, recovery and accuracy, when available.
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Affiliation(s)
- Sultan Aitekenov
- School of Sciences and Humanities, Department of Chemistry, Nazarbaev University, Nur-Sultan, Kazakhstan
| | - Abduzhappar Gaipov
- School of Medicine, Department of Clinical Sciences, Nazarbaev University, Nur-Sultan, Kazakhstan
| | - Rostislav Bukasov
- School of Sciences and Humanities, Department of Chemistry, Nazarbaev University, Nur-Sultan, Kazakhstan.
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17
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Hodel NC, Hamad A, Reither K, Kasella IM, Abdulla S, Schoetzau A, Hatz CFR, Mayr M. Comparison of Two Different Semiquantitative Urinary Dipstick Tests with Albumin-to-Creatinine Ratio for Screening and Classification of Albuminuria According to KDIGO. A Diagnostic Test Study. Diagnostics (Basel) 2021; 11:diagnostics11010081. [PMID: 33419091 PMCID: PMC7825407 DOI: 10.3390/diagnostics11010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Semiquantitative dipstick tests are utilized for albuminuria screening. Methods: In a prospective cross-sectional survey, we analyzed the diagnostic test validity of the semiquantitative colorimetric indicator-dye-based Combur9-Test® and the albumin-specific immunochromatographic assay Micral-Test® for the detection of albuminuria, the distribution of the semiquantitative measurements within the albuminuria stages according to KDIGO, and the utility for albuminuria screening compared with an albumin-to-creatinine ratio (ACR) in a walk-in population. Results: In 970 subjects, albuminuria (≥30 mg/g) was detected in 12.7% (95% CI 85.6–96.3%) with the ACR. Sensitivity was 82.9% (95% CI 75.1–89.1%) and 91.9% (95% CI 88.7–96.9%) and specificity 71.5% (95% CI 68.4–74.6%) and 17.5% (95% CI 15.0–20.2%) for the Combur9-Test® and Micral-Test®, respectively. Correct classification to KDIGO albuminuria stages A2/A3 with the Combur9-Test® was 15.4%, 51.4%, and 87.9% at cut-offs of 30, 100, and ≥300 mg/dL, and with the Micral-Test® it was 1.8%, 10.5%, and 53.6% at cut-offs of 2, 5, and 10 mg/dL, respectively. Overall, disagreement to KDIGO albuminuria was seen in 27% and 73% with the Combur9-Test® and Micral-Test®, respectively. From the total population, 62.5% and 15.3% were correctly ruled out and 2.2% and 1% were missed as false-negatives by the Combur9-Test® and Micral-Test®, respectively. Conclusion: Compared to the Combur9-Test®, the utility of the Micral-Test® is limited, because the fraction of correctly ruled out patients is small and a large proportion with a positive Micral-Test® require a subsequent ACR conformation test.
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Affiliation(s)
- Nikolai C. Hodel
- Medical Outpatient Department, University Hospital Basel, 4031 Basel, Switzerland;
- Clinical Research Unit, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland; (K.R.); (C.F.R.H.)
| | - Ali Hamad
- Chronic Disease Clinic, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania; (A.H.); (S.A.)
| | - Klaus Reither
- Clinical Research Unit, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland; (K.R.); (C.F.R.H.)
- Chronic Disease Clinic, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania; (A.H.); (S.A.)
- Faculty of Science, University of Basel, 4001 Basel, Switzerland;
| | | | - Salim Abdulla
- Chronic Disease Clinic, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania; (A.H.); (S.A.)
| | | | - Christoph F. R. Hatz
- Clinical Research Unit, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland; (K.R.); (C.F.R.H.)
- Faculty of Science, University of Basel, 4001 Basel, Switzerland;
- Infectiology/Hospital Hygiene Department, Cantonal Hospital, 9007 St. Gallen, Switzerland
| | - Michael Mayr
- Medical Outpatient Department, University Hospital Basel, 4031 Basel, Switzerland;
- Correspondence:
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18
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Gaipov A, Utegulov Z, Bukasov R, Turebekov D, Tarlykov P, Markhametova Z, Nurekeyev Z, Kunushpayeva Z, Sultangaziyev A. Development and validation of hybrid Brillouin-Raman spectroscopy for non-contact assessment of mechano-chemical properties of urine proteins as biomarkers of kidney diseases. BMC Nephrol 2020; 21:229. [PMID: 32539773 PMCID: PMC7296939 DOI: 10.1186/s12882-020-01890-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Proteinuria is a major marker of chronic kidney disease (CKD) progression and the predictor of cardiovascular mortality. The rapid development of renal failure is expected in those patients who have higher level of proteinuria however, some patients may have slow decline of renal function despite lower level of urinary protein excretion. The different mechanical (visco-elastic) and chemical properties, as well as the proteome profiles of urinary proteins might explain their tubular toxicity mechanism. Brillouin light scattering (BLS) and surface enhanced Raman scattering (SERS) spectroscopies are non-contact, laser optical-based techniques providing visco-elastic and chemical property information of probed human biofluids. We proposed to study and compare these properties of urinary proteins using BLS and SERS spectroscopies in nephrotic patient and validate hybrid BLS-SERS spectroscopy in diagnostic of urinary proteins as well as their profiling. The project ultimately aims for the development of an optical spectroscopic sensor for rapid, non-contact monitoring of urine samples from patients in clinical settings. METHODS BLS and SERS spectroscopies will be used for non-contact assessment of urinary proteins in proteinuric patients and healthy subjects and will be cross-validated by Liquid Chromatography-Mass Spectrometry (LC-MS). Participants will be followed-up during the 1 year and all adverse events such as exacerbation of proteinuria, progression of CKD, complications of nephrotic syndrome, disease relapse rate and inefficacy of treatment regimen will be registered referencing incident dates. Associations between urinary protein profiles (obtained from BLS and SERS as well as LC-MS) and adverse outcomes will be evaluated to identify most unfavored protein profiles. DISCUSSION This prospective study is focused on the development of non-contact hybrid BLS - SERS sensing tool and its clinical deployment for diagnosis and prognosis of proteinuria. We will identify the most important types of urine proteins based on their visco-elasticity, amino-acid profile and molecular weight responsible for the most severe cases of proteinuria and progressive renal function decline. We will aim for the developed hybrid BLS - SERS sensor, as a new diagnostic & prognostic tool, to be transferred to other biomedical applications. TRIAL REGISTRATION The trial has been approved by ClinicalTrials.gov (Trial registration ID NCT04311684). The date of registration was March 17, 2020.
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Affiliation(s)
- Abduzhappar Gaipov
- Department of Clinical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan, 010000.
| | - Zhandos Utegulov
- Department of Physics, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan, 010000
| | - Rostislav Bukasov
- Department of Chemistry, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan, 010000
| | - Duman Turebekov
- Department of Internal Medicine, Astana Medical University, Nur-Sultan, Kazakhstan, 010000
| | - Pavel Tarlykov
- Department of Proteomics and Mass Spectrometry, National Center for Biotechnology, Nur-Sultan, Kazakhstan, 010000
| | - Zhannur Markhametova
- Department of Clinical Sciences, Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan, 010000
| | - Zhangatay Nurekeyev
- Department of Physics, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan, 010000
| | - Zhanar Kunushpayeva
- Department of Chemistry, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan, 010000
| | - Alisher Sultangaziyev
- Department of Chemistry, School of Sciences and Humanities, Nazarbayev University, Nur-Sultan, Kazakhstan, 010000
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Giralt-López A, Molina-Van den Bosch M, Vergara A, García-Carro C, Seron D, Jacobs-Cachá C, Soler MJ. Revisiting Experimental Models of Diabetic Nephropathy. Int J Mol Sci 2020; 21:ijms21103587. [PMID: 32438732 PMCID: PMC7278948 DOI: 10.3390/ijms21103587] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/12/2022] Open
Abstract
Diabetes prevalence is constantly increasing and, nowadays, it affects more than 350 million people worldwide. Therefore, the prevalence of diabetic nephropathy (DN) has also increased, becoming the main cause of end-stage renal disease (ESRD) in the developed world. DN is characterized by albuminuria, a decline in glomerular filtration rate (GFR), hypertension, mesangial matrix expansion, glomerular basement membrane thickening, and tubulointerstitial fibrosis. The therapeutic advances in the last years have been able to modify and delay the natural course of diabetic kidney disease (DKD). Nevertheless, there is still an urgent need to characterize the pathways that are involved in DN, identify risk biomarkers and prevent kidney failure in diabetic patients. Rodent models provide valuable information regarding how DN is set and its progression through time. Despite the utility of these models, kidney disease progression depends on the diabetes induction method and susceptibility to diabetes of each experimental strain. The classical DN murine models (Streptozotocin-induced, Akita, or obese type 2 models) do not develop all of the typical DN features. For this reason, many models have been crossed to a susceptible genetic background. Knockout and transgenic strains have also been created to generate more robust models. In this review, we will focus on the description of the new DN rodent models and, additionally, we will provide an overview of the available methods for renal phenotyping.
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Affiliation(s)
- Anna Giralt-López
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
| | - Mireia Molina-Van den Bosch
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
| | - Ander Vergara
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
- Nephrology Department, Vall d’Hebrón Hospital, 08035 Barcelona, Spain
| | - Clara García-Carro
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
- Nephrology Department, Vall d’Hebrón Hospital, 08035 Barcelona, Spain
| | - Daniel Seron
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
- Nephrology Department, Vall d’Hebrón Hospital, 08035 Barcelona, Spain
| | - Conxita Jacobs-Cachá
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
- Correspondence: (C.J.-C.); (M.J.S.)
| | - Maria José Soler
- Nephrology Research Group, Vall d’Hebrón Institut de Recerca, 08035 Barcelona, Spain; (A.G.-L.); (M.M.-V.d.B.); (A.V.); (C.G.-C.); (D.S.)
- Nephrology Department, Vall d’Hebrón Hospital, 08035 Barcelona, Spain
- Correspondence: (C.J.-C.); (M.J.S.)
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20
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Treacy O, Brown NN, Dimeski G. Biochemical evaluation of kidney disease. Transl Androl Urol 2019; 8:S214-S223. [PMID: 31236339 PMCID: PMC6559936 DOI: 10.21037/tau.2018.10.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/08/2018] [Indexed: 12/17/2022] Open
Abstract
Different biochemical markers exist in both blood and urine for assessing renal function. Most of these biomarkers have advantages and limitations associated with their use, which is important to consider when ordering and utilising them in the clinical setting. The ideal marker should be able to detect acute kidney injury (AKI) at the onset and be used for the diagnosis and ongoing monitoring and management of kidney disease. The search for such a marker is ongoing, as all potential candidates thus far are associated with certain limitations. This article will attempt to compare and contrast established and emerging kidney disease markers.
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Affiliation(s)
- Oliver Treacy
- Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital Ipswich Road, Woolloongabba, Queensland, Australia
| | - Nigel N. Brown
- Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital Ipswich Road, Woolloongabba, Queensland, Australia
| | - Goce Dimeski
- Department of Chemical Pathology, Pathology Queensland, Princess Alexandra Hospital Ipswich Road, Woolloongabba, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
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21
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Acute kidney failure and discrepant values of urinary proteins: When the case is not "crystal clear". Clin Biochem 2019; 67:60-62. [PMID: 30890413 DOI: 10.1016/j.clinbiochem.2019.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/24/2019] [Accepted: 03/16/2019] [Indexed: 11/20/2022]
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22
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Kim HY, Kong YG, Park JH, Kim YK. Acute kidney injury after burn surgery: Preoperative neutrophil/lymphocyte ratio as a predictive factor. Acta Anaesthesiol Scand 2019; 63:240-247. [PMID: 30203468 DOI: 10.1111/aas.13255] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 06/29/2018] [Accepted: 08/08/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Severe inflammation and acute kidney injury (AKI) are serious adverse events after burn injuries. The neutrophil/lymphocyte ratio (NLR) is a marker of inflammation. We evaluated the independent risk factors for postoperative AKI, including NLR, in burn-injured patients. METHODS The preoperative, intraoperative, and postoperative variables of 473 burn-injured patients were collected. The risk factors for AKI after burn surgery were evaluated using univariate and multivariate logistic regression analyses. The receiver operating characteristic (ROC) curve analysis of preoperative NLR was performed. The 3-month mortality after surgery was also compared between AKI and non-AKI groups using Kaplan-Meier analysis with a log-rank test. RESULTS Postoperative AKI occurred in 71 of 473 (15.0%) burn patients. The total body surface area burned (odds ratio (OR), 1.013; 95% confidence interval (CI), 1.001-1.026; P = 0.037), inhalation injury (OR, 1.821; 95% CI, 1.008-3.292; P = 0.047), and preoperative NLR (OR, 1.094; 95% CI, 1.064-1.125; P < 0.001) were risk factors for AKI after surgery. The area under the ROC curve was 0.767, with an optimal cut-off value of 11.7. Moreover, the 3-month mortality after surgery was significantly higher in the AKI group than in the non-AKI group (49.3% vs 14.9%, P < 0.001). CONCLUSION Total body surface area burned, inhalation injury, and preoperative NLR are risk factors for AKI after burn surgery, which is associated with early postoperative mortality. Preoperative NLR can provide useful information for the early detection of postoperative AKI and subsequent mortality in burn-injured patients.
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Affiliation(s)
- Hee Yeong Kim
- Department of Anesthesiology and Pain Medicine; Hangang Sacred Heart Hospital; Hallym University College of Medicine; Seoul Korea
| | - Yu-Gyeong Kong
- Department of Anesthesiology and Pain Medicine; Hangang Sacred Heart Hospital; Hallym University College of Medicine; Seoul Korea
| | - Ji Hyun Park
- Department of Anesthesiology and Pain Medicine; Hangang Sacred Heart Hospital; Hallym University College of Medicine; Seoul Korea
| | - Young-Kug Kim
- Department of Anesthesiology and Pain Medicine; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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23
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Abstract
Here we present a method for a mobile point-of-care (POC) testing of urinary albumin concentration, a biomarker of kidney damage and cardiovascular disease. The self-testing strips are meant to be interpreted by means of a smartphone application. The limits of detection range from 0.15 to 0.30 g/L urinary albumin, though results below 0.10 g/L are presented in a quantitative manner and estimates larger than this threshold are shown as categorical variables in a qualitative manner for increasing urinary albumin concentrations. Calibrated once under standard conditions, the app enables the user to capture problem samples and calculate the corresponding concentration. Negative and positive findings must be interpreted, taking into account the inherent limitations of the method, and professional health advice must be requested for diagnostic considerations. Acknowledgment of the association between early life nutrition and long-term renal health and the adoption of preventive strategies targeting high-risk groups is key for the reduction of the burden of chronic kidney disease on a global scale.
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Affiliation(s)
- P R Matías-García
- Institute of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
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24
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Krane LS, Heavner MG, Peyton C, Rague JT, Hemal AK. Association of Urine Dipstick Proteinuria and Postoperative Renal Function Following Robotic Partial Nephrectomy. J Endourol 2016; 30:532-6. [DOI: 10.1089/end.2015.0737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Louis S. Krane
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Matthew G. Heavner
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Charles Peyton
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - James T. Rague
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Ashok K. Hemal
- Department of Urology, Wake Forest Baptist Health, Winston-Salem, North Carolina
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25
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Estimated glomerular filtration rate and albuminuria in Korean population evaluated for cardiovascular risk. Int Urol Nephrol 2016; 48:759-64. [PMID: 26905406 DOI: 10.1007/s11255-016-1244-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/08/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE This study's purpose was to examine established cardiovascular risk prediction model scores for their associations with albuminuria and estimated glomerular filtration rate (eGFR) in Korean population. METHODS We calculated the 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimated score, Korean coronary heart disease risk prediction score (KRS), and the Adult Treatment Panel (ATP) III risk score for 9733 South Koreans, aged 40-79 years, who were not diagnosed with stroke, angina pectoris, or myocardial ischemia using data from the 2011-2013 Korea National Health and Nutrition Examination Survey. RESULTS The associations between cardiovascular risk model scores and the urine albumin-to-creatinine ratio (UACR) and eGFR tended to be stronger for the ASCVD risk score than for the other risk scores. The area under the receiver operating characteristic curve for increased albuminuria (UACR ≥ 30 mg/g) and decreased eGFR (<60 mL/min/1.73 m(2)) was significantly higher for the ASCVD risk score than for the ATP III risk score and the KRS (except for increased albuminuria in women). CONCLUSIONS The ASCVD risk score had a stronger relationship with and better predicted albuminuria and eGFR than did the KRS and ATP III risk score.
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26
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Steffen P, Kwiatkowski M, Robertson WD, Zarrine-Afsar A, Deterra D, Richter V, Schlüter H. Protein species as diagnostic markers. J Proteomics 2016; 134:5-18. [DOI: 10.1016/j.jprot.2015.12.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/28/2015] [Accepted: 12/09/2015] [Indexed: 02/07/2023]
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27
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Liang H, Kennedy C, Manne S, Lin JHL, Dolin P. Monitoring for proteinuria in patients with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2015; 3:e000071. [PMID: 25893098 PMCID: PMC4395799 DOI: 10.1136/bmjdrc-2014-000071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/27/2015] [Accepted: 02/03/2015] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The UK National Institute for Health and Care Excellence (NICE) guideline on diabetes recommends at least annual monitoring of patients with type 2 diabetes mellitus (T2DM) for proteinuria. To date, little has been published on the frequency of proteinuria monitoring in T2DM, and its association with risk factors for renal complications. We aimed to describe proteinuria monitoring in patients with T2DM. DESIGN This study identified patients with T2DM aged 40 years or older with the first antidiabetic drug use in 2007-2012 (cohort entry) in the UK Clinical Practice Research Datalink. At least 1 year of registration before and after cohort entry was required. A test was considered undertaken if a medical or laboratory code indicated a urinary albumin or protein test. The percentage of patients with at least one test performed was obtained in 1 year after cohort entry and any time during follow-up. A Cox proportional hazards model was used to estimate the HRs of patients having the first screening test while adjusting for baseline covariates. RESULTS 65 790 patients (mean age 63.0 years, men 57.5%, mean follow-up 41.0 months) were included, of whom 49 707 (75.6%) patients had at least one test in 1 year after antidiabetic drug initiation and 59 400 (90.3%) had at least one test any time during follow-up. Proteinuria monitoring decreased with time since initiation of antidiabetic drug therapy and with number of treatment changes and was independently associated with age, sex, smoking status, and year of antidiabetic drug initiation. 12.3% of patients with T2DM tested had a positive proteinuria test for the first screening performed in 1 year after initiation of antidiabetic drug therapy. CONCLUSIONS The findings suggested suboptimal compliance with the NICE guideline on proteinuria monitoring in patients with T2DM and that level of monitoring appeared to depend on multiple clinical factors.
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Affiliation(s)
- Huifang Liang
- Department of Pharmacoepidemiology, Takeda Development Center Americas, Inc., Deerfield, Illinois, USA
| | - Caroline Kennedy
- Department of Global Statistics, Takeda Development Centre Europe Ltd., London, UK
| | - Sudhakar Manne
- Observational Research Analytics, Takeda Development Center Americas, Inc., Deerfield, USA
| | | | - Paul Dolin
- Department of Pharmacoepidemiology, Takeda Development Centre Europe Ltd., London, UK
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28
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Musante L, Tataruch DE, Holthofer H. Use and isolation of urinary exosomes as biomarkers for diabetic nephropathy. Front Endocrinol (Lausanne) 2014; 5:149. [PMID: 25309511 PMCID: PMC4176463 DOI: 10.3389/fendo.2014.00149] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/05/2014] [Indexed: 01/08/2023] Open
Abstract
Diabetes represents a major threat to public health and the number of patients is increasing alarmingly in the global scale. Particularly, the diabetic kidney disease (nephropathy, DN) together with its cardiovascular complications cause immense human suffering, highly increased risk of premature deaths, and lead to huge societal costs. DN is first detected when protein appears in urine (microalbuminuria). As in other persisting proteinuric diseases (like vasculitis) it heralds irreversible damage of kidney functions up to non-functional (end-stage) kidney and ultimately calls for kidney replacement therapy (dialysis or kidney transplantation). While remarkable progress has been made in understanding the genetic and molecular factors associating with chronic kidney diseases, breakthroughs are still missing to provide comprehensive understanding of events and mechanisms associated. Non-invasive diagnostic tools for early diagnostics of kidney damage are badly needed. Exosomes - small vesicular structures present in urine are released by all cell types along kidney structures to present with distinct surface assembly. Furthermore, exosomes carry a load of special proteins and nucleic acids. This "cargo" faithfully reflects the physiological state of their respective cells of origin and appears to serve as a new pathway for downstream signaling to target cells. Accordingly, exosome vesicles are emerging as a valuable source for disease stage-specific information and as fingerprints of disease progression. Unfortunately, technical issues of exosome isolation are challenging and, thus, their full potential remains untapped. Here, we review the molecular basis of exosome secretion as well as their use to reveal events along the nephron. In addition to novel molecular information, the new methods provide the needed accurate, personalized, non-invasive, and inexpensive future diagnostics.
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Affiliation(s)
- Luca Musante
- Centre for BioAnalytical Sciences (CBAS), Dublin City University, Dublin, Ireland
| | - Dorota Ewa Tataruch
- Centre for BioAnalytical Sciences (CBAS), Dublin City University, Dublin, Ireland
| | - Harry Holthofer
- Centre for BioAnalytical Sciences (CBAS), Dublin City University, Dublin, Ireland
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29
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Kim HH, Kim JY, Kim SJ, Park ES, Shin SJ, Kang KY, Hong YS, Yoon HE. Overflow proteinuria as a manifestation of unrecognized polymyositis. Int Med Case Rep J 2014; 7:71-4. [PMID: 24729735 PMCID: PMC3979789 DOI: 10.2147/imcrj.s60885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Polymyositis is a rare and gradually progressive autoimmune disease of skeletal muscle. Two main types of renal involvement have been described: acute tubular necrosis related to rhabdomyolysis and glomerulonephritis. However, cases of overflow proteinuria related to polymyositis have rarely been reported. Herein, we report a case of a 41-year-old male who presented with edema of both lower extremities. Laboratory studies revealed elevated creatine phosphokinase level, hypoalbuminemia, and a moderate amount of proteinuria, although albuminuria was not dominant. Urine electrophoresis showed an abnormally restricted zone in the β-fraction, which suggested overflow proteinuria of non-glomerular origin. Despite intravenous hydration, his serum creatine phosphokinase level did not decrease and his symptoms did not improve. Electromyography showed myopathy, and muscle biopsy revealed findings consistent with polymyositis. After corticosteroid therapy, his creatine phosphokinase level and proteinuria decreased and his clinical symptoms improved. This case demonstrates an atypical presentation of polymyositis manifested by overflow proteinuria.
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Affiliation(s)
- Hyun Ho Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Jae Young Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Sung Jun Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea ; Division of Nephrology, Department of Internal Medicine, Incheon St Mary's Hospital, Republic of Korea
| | - Eun Su Park
- Department of Pathology, Incheon St Mary's Hospital, Republic of Korea
| | - Seok Joon Shin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea ; Division of Nephrology, Department of Internal Medicine, Incheon St Mary's Hospital, Republic of Korea
| | - Kwi Young Kang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea ; Division of Rheumatology, Department of Internal Medicine, Incheon St Mary's Hospital, Incheon, Republic of Korea
| | - Yeon Sik Hong
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea ; Division of Rheumatology, Department of Internal Medicine, Incheon St Mary's Hospital, Incheon, Republic of Korea
| | - Hye Eun Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Republic of Korea ; Division of Nephrology, Department of Internal Medicine, Incheon St Mary's Hospital, Republic of Korea
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30
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Sandilands EA, Dhaun N, Dear JW, Webb DJ. Measurement of renal function in patients with chronic kidney disease. Br J Clin Pharmacol 2013; 76:504-15. [PMID: 23802624 PMCID: PMC3791974 DOI: 10.1111/bcp.12198] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 06/07/2013] [Indexed: 12/13/2022] Open
Abstract
Chronic kidney disease affects millions of people worldwide and is associated with an increased morbidity and mortality as a result of kidney failure and cardiovascular disease. Accurate assessment of kidney function is important in the clinical setting as a screening tool and for monitoring disease progression and guiding prognosis. In clinical research, the development of new methods to measure kidney function accurately is important in the search for new therapeutic targets and the discovery of novel biomarkers to aid early identification of kidney injury. This review considers different methods for measuring kidney function and their contribution to the improvement of detection, monitoring and treatment of chronic kidney disease.
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Affiliation(s)
- Euan A Sandilands
- National Poisons Information Service Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK
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31
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Caneparo V, Cena T, De Andrea M, Dell'Oste V, Stratta P, Quaglia M, Tincani A, Andreoli L, Ceffa S, Taraborelli M, Magnani C, Landolfo S, Gariglio M. Anti-IFI16 antibodies and their relation to disease characteristics in systemic lupus erythematosus. Lupus 2013; 22:607-13. [DOI: 10.1177/0961203313484978] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective Several studies have shown the presence of anti-IFI16 antibodies in systemic lupus erythematosus (SLE), Sjögren Syndrome (SjS), systemic sclerosis (SSc) and other autoimmune diseases. However, the significance of anti-IFI16 antibodies in SLE has not been fully characterized. The aim of this study was to investigate associations between anti-IFI16 antibodies and clinical and serologic parameters of SLE. Methods An enzyme-linked immunosorbent assay (ELISA) kit was used to measure anti-IFI16 antibodies in the sera of 168 SLE patients, 46 patients with any type of primary glomerulonephritis (GN) and 182 healthy controls (HCs). Associations between anti-IFI16 antibodies and clinical and serologic parameters of SLE were statistically evaluated using both univariate and multivariate analysis. Results Significantly higher anti-IFI16 titres were observed in SLE patients compared to both non-SLE GN and HCs (median levels: 270.1 U/ml vs 132.1 U/ml, p = 0.001, and 52.9 U/ml, p < 0.0001, respectively). With cut-off levels corresponding to the 95th percentile of the control population (113 U/ml), 63% of the SLE patients tested positive for anti-IFI16 autoantibodies, compared to just 24% of patients with primary non-SLE GN and 5% of HCs. The presence of anti-IFI16 antibodies inversely correlated with proteinuria (univariate analysis) and C3 hypocomplementaemia (univariate and multivariate analyses). Conclusions The inverse correlations observed between anti-IFI16 positivity, proteinuria and C3 hypocomplementaemia suggest that anti-IFI16 antibodies do not contribute to renal inflammation in SLE; indeed they may even prevent complement consumption. Anti-IFI16 antibodies hold the potential to serve as a new biomarker of disease activity in SLE.
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Affiliation(s)
- V Caneparo
- Department of Translational Medicine, Medical School of Novara, Italy
- NoToPharm s.r.l, Italy
| | - T Cena
- Department of Translational Medicine, Medical School of Novara, Italy
- Unit of Medical Statistics and Cancer Epidemiology, University-Hospital “Maggiore della Carità”, Italy
| | - M De Andrea
- Department of Translational Medicine, Medical School of Novara, Italy
- Department of Public Health and Pediatric Sciences, Medical School of Turin, Italy
| | - V Dell'Oste
- NoToPharm s.r.l, Italy
- Department of Public Health and Pediatric Sciences, Medical School of Turin, Italy
| | - P Stratta
- Department of Translational Medicine, Medical School of Novara, Italy
- Nephrology Unit, University-Hospital “Maggiore della Carità”, Italy
| | - M Quaglia
- Department of Translational Medicine, Medical School of Novara, Italy
- Nephrology Unit, University-Hospital “Maggiore della Carità”, Italy
| | - A Tincani
- Department of Clinical and Experimental Science, University of Brescia, Italy
- Rheumatology and Clinical Immunology Unit, Spedali Civili, Italy
| | - L Andreoli
- Department of Clinical and Experimental Science, University of Brescia, Italy
- Rheumatology and Clinical Immunology Unit, Spedali Civili, Italy
| | - S Ceffa
- Department of Clinical and Experimental Science, University of Brescia, Italy
- Rheumatology and Clinical Immunology Unit, Spedali Civili, Italy
| | - M Taraborelli
- Department of Clinical and Experimental Science, University of Brescia, Italy
- Rheumatology and Clinical Immunology Unit, Spedali Civili, Italy
| | - C Magnani
- Department of Translational Medicine, Medical School of Novara, Italy
- Unit of Medical Statistics and Cancer Epidemiology, University-Hospital “Maggiore della Carità”, Italy
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Medical School of Novara, Italy
| | - S Landolfo
- NoToPharm s.r.l, Italy
- Department of Public Health and Pediatric Sciences, Medical School of Turin, Italy
| | - M Gariglio
- Department of Translational Medicine, Medical School of Novara, Italy
- NoToPharm s.r.l, Italy
- Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), Medical School of Novara, Italy
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32
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Understanding the mechanisms of proteinuria: therapeutic implications. Int J Nephrol 2012; 2012:546039. [PMID: 22844592 PMCID: PMC3398673 DOI: 10.1155/2012/546039] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/30/2012] [Indexed: 12/18/2022] Open
Abstract
A large body of evidence indicates that proteinuria is a strong predictor of morbidity, a cause of inflammation, oxidative stress and progression of chronic kidney disease, and development of cardiovascular disease. The processes that lead to proteinuria are complex and involve factors such as glomerular hemodynamic, tubular absorption, and diffusion gradients. Alterations in various different molecular pathways and interactions may lead to the identical clinical end points of proteinuria and chronic kidney disease. Glomerular diseases include a wide range of immune and nonimmune insults that may target and thus damage some components of the glomerular filtration barrier. In many of these conditions, the renal visceral epithelial cell (podocyte) responds to injury along defined pathways, which may explain the resultant clinical and histological changes. The recent discovery of the molecular components of the slit diaphragm, specialized structure of podocyte-podocyte interaction, has been a major breakthrough in understanding the crucial role of the epithelial layer of the glomerular barrier and the pathogenesis of proteinuria. This paper provides an overview and update on the structure and function of the glomerular filtration barrier and the pathogenesis of proteinuria, highlighting the role of the podocyte in this setting. In addition, current antiproteinuric therapeutic approaches are briefly commented.
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33
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Albuminurie. Internist (Berl) 2012; 53:38-44. [DOI: 10.1007/s00108-011-2891-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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