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Yudhana A, Mukhopadhyay S, Prima ODA, Akbar SA, Nuraisyah F, Mufandi I, Fauzi KH, Nasyah NA. Multi sensor application-based for measuring the quality of human urine on first-void urine. SENSING AND BIO-SENSING RESEARCH 2021. [DOI: 10.1016/j.sbsr.2021.100461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Lee CC, Chang CH, Chen SW, Fan PC, Chang SW, Chen YT, Nan YY, Lin PJ, Tsai FC. Preoperative risk assessment improves biomarker detection for predicting acute kidney injury after cardiac surgery. PLoS One 2018; 13:e0203447. [PMID: 30180211 PMCID: PMC6122821 DOI: 10.1371/journal.pone.0203447] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 08/21/2018] [Indexed: 01/22/2023] Open
Abstract
Background Although urinary neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a promising biomarker for the early detection of kidney injury, previous studies of adult patients who underwent cardiac surgery have reported only moderate discrimination. The age, creatinine, and ejection fraction (ACEF) score is a preoperative validated risk model with satisfactory accuracy for predicting AKI following cardiac surgery. It remains unknown whether combining preoperative risk assessment through ACEF scores followed by urinary NGAL test in a population of high-risk individuals is an optimal approach with improved predictive performance. Material and methods A total of 177 consecutive patients who underwent cardiac surgery were enrolled. Clinical characteristics, prognostic model scores, and outcomes were assessed. Urinary NGAL were examined within 6 hours after cardiac surgery. Patients were stratified according to preoperative ACEF scores, and comparisons were made using the area under the receiver operator characteristic curve (AUROC) for the prediction of AKI. Results A total of 45.8% (81/177) of the patients had AKI. As expected, patients with ACEF scores ≥ 1.1 were older and more likely to have class III or IV heart failure. They were also more likely to have diabetes mellitus, myocardial infarction, and peripheral arterial disease. Urinary NGAL alone moderately predicted AKI, with an AUROC of 0.732. Risk stratification by ACEF scores ≥ 1.1 substantially improved the AUROC of urinary NGAL to 0.873 (95% confidence interval, 0.784–0.961; P < .001). Conclusions Risk stratification by preoperative ACEF scores ≥ 1.1, followed by postoperative urinary NGAL, provides more satisfactory risk discrimination than does urinary NGAL alone for the early detection of AKI after cardiac surgery. Future studies should investigate whether this strategy could improve the outcomes and cost-effectiveness of care in patients undergoing cardiac surgery.
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Affiliation(s)
- Cheng-Chia Lee
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hsiang Chang
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Wei Chen
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail:
| | - Pei-Chun Fan
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Su-Wei Chang
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Ting Chen
- Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Yun Nan
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pyng-Jing Lin
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Feng-Chun Tsai
- Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Urinary microprotein concentrations in the long-term follow-up of dilating vesicoureteral reflux patients who underwent medical or surgical treatment. Int Urol Nephrol 2015; 48:5-11. [PMID: 26560475 DOI: 10.1007/s11255-015-1097-7] [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: 07/24/2015] [Accepted: 08/24/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE This study examined the relationship between urinary microprotein concentrations and renal functional parameters in children with dilating (grade III-V) vesicoureteral reflux (VUR) who underwent either medical or surgical treatment. METHODS All 44 dilating VUR patients who were followed for 4 years were screened for inclusion in this study. The patients' clinical features and clinical outcomes, as well as the urinary activities of albumin (ALB), transferrin (TRF), immunoglobulin G (IgG), alpha-1-microglobulin (α1-MG), and N-acetyl-β-glucosaminidase (NAG), were retrospectively analyzed. RESULTS High values of NAG, α1-MG, IgG, TRF, and ALB were noted in 73.33, 58.33, 43.33, 24.14, and 53.33 % of patients, respectively, at the first examination. Cystatin C, eGFR, and urinary microprotein levels were associated with a good prognosis after 4 years of follow-up. No differences in recurrent UTI, cystatin C concentration, most microprotein/creatinine (Cr) ratios, eGFR, or ΔGFR4 % were found between the groups. High levels of urinary proteins were found in 2.38-9.52 % of cases after 4 years of follow-up. ALB/Cr, IgG/Cr, and α1-MG/Cr levels were positively correlated with 99mTc-dimercaptosuccinic acid (DMSA) grade, and α1-MG excretion was inversely correlated with eGFR. CONCLUSIONS The levels of microprotein were elevated at diagnosis in a higher proportion of patients than for the other markers examined. At long-term follow-up, the reflux level had decreased or completely resolved in all patients, and the proportions of microproteins that were elevated were significantly reduced. Renal impairment measured by eGFR and DMSA grade was related to increased urinary α1-MG levels.
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Gerritsen KGF, Leeuwis JW, Koeners MP, Bakker SJL, van Oeveren W, Aten J, Tarnow L, Rossing P, Wetzels JFM, Joles JA, Kok RJ, Goldschmeding R, Nguyen TQ. Elevated Urinary Connective Tissue Growth Factor in Diabetic Nephropathy Is Caused by Local Production and Tubular Dysfunction. J Diabetes Res 2015; 2015:539787. [PMID: 26171399 PMCID: PMC4485941 DOI: 10.1155/2015/539787] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/27/2015] [Accepted: 06/03/2015] [Indexed: 01/28/2023] Open
Abstract
Connective tissue growth factor (CTGF; CCN2) plays a role in the development of diabetic nephropathy (DN). Urinary CTGF (uCTGF) is elevated in DN patients and has been proposed as a biomarker for disease progression, but it is unknown which pathophysiological factors contribute to elevated uCTGF. We studied renal handling of CTGF by infusion of recombinant CTGF in diabetic mice. In addition, uCTGF was measured in type 1 DN patients and compared with glomerular and tubular dysfunction and damage markers. In diabetic mice, uCTGF was increased and fractional excretion (FE) of recombinant CTGF was substantially elevated indicating reduced tubular reabsorption. FE of recombinant CTGF correlated with excretion of endogenous CTGF. CTGF mRNA was mainly localized in glomeruli and medullary tubules. Comparison of FE of endogenous and recombinant CTGF indicated that 60% of uCTGF had a direct renal source, while 40% originated from plasma CTGF. In DN patients, uCTGF was independently associated with markers of proximal and distal tubular dysfunction and damage. In conclusion, uCTGF in DN is elevated as a result of both increased local production and reduced reabsorption due to tubular dysfunction. We submit that uCTGF is a biomarker reflecting both glomerular and tubulointerstitial hallmarks of diabetic kidney disease.
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Affiliation(s)
- Karin G. F. Gerritsen
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
| | - Jan Willem Leeuwis
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
| | - Maarten P. Koeners
- Department of Nephrology and Hypertension, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University Medical Center Groningen, 9700 RB Groningen, Netherlands
| | | | - Jan Aten
- Department of Pathology, Academic Medical Center, 1105 AZ Amsterdam, Netherlands
| | - Lise Tarnow
- Steno Diabetes Center, 2820 Gentofte, Denmark
| | | | - Jack F. M. Wetzels
- Department of Nephrology, Radboud University Nijmegen Medical Centre, 6525 GA Nijmegen, Netherlands
| | - Jaap A. Joles
- Department of Nephrology and Hypertension, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
| | - Robbert Jan Kok
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, Netherlands
| | - Roel Goldschmeding
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
| | - Tri Q. Nguyen
- Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands
- *Tri Q. Nguyen:
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Tramonti G, Kanwar YS. Review and discussion of tubular biomarkers in the diagnosis and management of diabetic nephropathy. Endocrine 2013; 43:494-503. [PMID: 23086402 PMCID: PMC3670820 DOI: 10.1007/s12020-012-9820-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 10/09/2012] [Indexed: 01/14/2023]
Abstract
The prevalence of diabetic nephropathy has tremendously increased with the relentless rise in the incidence of diabetes over the last couple decades. Diabetic nephropathy is a leading cause of morbidity and mortality, and it invariably leads to an end-stage renal disease (ESRD). In an effort to delay the onset of ESRD systematic screening and appropriate management are needed to evaluate the progression of renal damage in diabetic nephropathy. The reliability of current tests in predicting the onset, progression and response to various regimens for diabetic nephropathy is still under debate; and it has engendered a search for more sensitive and specific urinary biomarkers, especially those reflective of tubular dysfunctions. It is well-known that there is a good correlation between the degree of damage to the tubulo-interstitial compartment and the deterioration of renal functions. In view of this, the utility of urinary biomarkers, reflective of tubular injury, reported in the literature is discussed in this brief review.
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Affiliation(s)
- Gianfranco Tramonti
- Dipartimento di Medicina Interna – Sezione di Nefrologia, Università di Pisa, Italy
| | - Yashpal S. Kanwar
- Department of Pathology, Feinberg School of Medicine, Northwestern University, 303 E. Chicago Avenue, Chicago, Illinois 60611, USA
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Nauta FL, Scheven L, Meijer E, van Oeveren W, de Jong PE, Bakker SJL, Gansevoort RT. Glomerular and tubular damage markers in individuals with progressive albuminuria. Clin J Am Soc Nephrol 2013; 8:1106-14. [PMID: 23539232 DOI: 10.2215/cjn.04510512] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Albuminuria is associated with risk for renal and cardiovascular disease. It is difficult to predict which persons will progress in albuminuria. This study investigated whether assessment of urinary markers associated with damage to different parts of the nephron may help identify individuals that will progress in albuminuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Individuals were selected from a prospective community-based cohort study with serial follow-up and defined as "progressors" if they belonged to the quintile of participants with the most rapid annual increase in albuminuria, and reached an albuminuria ≥150 mg/d during follow-up. Patients with known renal disease or macroalbuminuria at baseline were excluded. Each progressor was matched to two control participants, based on baseline albuminuria, age, and sex. Furthermore, damage markers were measured in a separate set of healthy individuals. RESULTS After a median follow-up of 8.6 years, 183 of 8394 participants met the criteria for progressive albuminuria. Baseline clinical characteristics were comparable between progressors and matched controls (n=366). Both had higher baseline albuminuria than the overall population. Urinary excretion of the glomerular damage marker IgG was significantly higher in progressors, whereas urinary excretion of proximal tubular damage markers and inflammatory markers was lower in these individuals compared with controls. Healthy individuals (n=109) had the lowest values for all urinary damage markers measured. CONCLUSIONS These data suggest that albuminuria associated with markers of glomerular damage is more likely to progress, whereas albuminuria associated with markers of tubulointerstitial damage is more likely to remain stable.
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Affiliation(s)
- Ferdau L Nauta
- Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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TING YITIAN, COATES PTOBY, WALKER ROBERTJ, MCLELLAN ALEXANDERD. Urinary tubular biomarkers as potential early predictors of renal allograft rejection. Nephrology (Carlton) 2011; 17:11-6. [DOI: 10.1111/j.1440-1797.2011.01536.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Shao C, Li M, Li X, Wei L, Zhu L, Yang F, Jia L, Mu Y, Wang J, Guo Z, Zhang D, Yin J, Wang Z, Sun W, Zhang Z, Gao Y. A tool for biomarker discovery in the urinary proteome: a manually curated human and animal urine protein biomarker database. Mol Cell Proteomics 2011; 10:M111.010975. [PMID: 21876203 DOI: 10.1074/mcp.m111.010975] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Urine is an important source of biomarkers. A single proteomics assay can identify hundreds of differentially expressed proteins between disease and control samples; however, the ability to select biomarker candidates with the most promise for further validation study remains difficult. A bioinformatics tool that allows accurate and convenient comparison of all of the existing related studies can markedly aid the development of this area. In this study, we constructed the Urinary Protein Biomarker (UPB) database to collect existing studies of urinary protein biomarkers from published literature. To ensure the quality of data collection, all literature was manually curated. The website (http://122.70.220.102/biomarker) allows users to browse the database by disease categories and search by protein IDs in bulk. Researchers can easily determine whether a biomarker candidate has already been identified by another group for the same disease or for other diseases, which allows for the confidence and disease specificity of their biomarker candidate to be evaluated. Additionally, the pathophysiological processes of the diseases can be studied using our database with the hypothesis that diseases that share biomarkers may have the same pathophysiological processes. Because of the natural relationship between urinary proteins and the urinary system, this database may be especially suitable for studying the pathogenesis of urological diseases. Currently, the database contains 553 and 275 records compiled from 174 and 31 publications of human and animal studies, respectively. We found that biomarkers identified by different proteomic methods had a poor overlap with each other. The differences between sample preparation and separation methods, mass spectrometers, and data analysis algorithms may be influencing factors. Biomarkers identified from animal models also overlapped poorly with those from human samples, but the overlap rate was not lower than that of human proteomics studies. Therefore, it is not clear how well the animal models mimic human diseases.
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Affiliation(s)
- Chen Shao
- National Key Laboratory of Medical Molecular Biology, Department of Physiology and Pathophysiology, Peking Union Medical College, 5 Dong Dan San Tiao, Beijing, China
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Lisowska-Myjak B, Krych A, Kołodziejczyk A, Pachecka J, Gaciong Z. Urinary proteins, N-acetyl-β-D-glucosaminidase activity and estimated glomerular filtration rate in hypertensive patients with normoalbuminuria and microalbuminuria. Nephrology (Carlton) 2011; 16:403-9. [PMID: 21265931 DOI: 10.1111/j.1440-1797.2011.01444.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of the study was to assess novel candidate markers measured in the urine of normoalbuminuric and microalbuminuric patients (the urinary albumin-to-creatinine ratio < 30 mg/mmol) with essential hypertension to be used for early detection and assessment of progressive deterioration in renal function. METHODS Albumin, α-1-antitrypsin, orosomucoid, transferrin, retinol-binding protein and α-1-microglobulin concentrations and the NAG (N-acetyl-β-D-glucosaminidase) activity in the urine were evaluated in 102 hypertensive subjects with urinary albumin-to-creatinine ratio (uACR) < 30 mg/mmol. The estimated glomerular filtration rate (e-GFR) was calculated using the Modification of Diet in Renal Disease Study equation. RESULTS The decreasing e-GFR values in normo- and microalbuminuric patients with essential hypertension were accompanied by significant increases (P < 0.05) in the NAG activity and uACR value in the urine. The e-GFR significantly (P < 0.05) correlated with the NAG activity in the urine, but no association was observed with the urinary concentrations of any of the individual proteins (P > 0.05). CONCLUSIONS In normoalbuminuric and microalbuminuric patients with essential hypertension renal impairment measured by e-GFR is related to the increased urinary NAG activity and uACR rather than elevated concentrations of individual proteins. Urinary NAG activity and uACR value seem independently promising candidate markers for use in assessing progression of early renal impairment in patients with hypertension.
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Affiliation(s)
- Barbara Lisowska-Myjak
- Department of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland. basia.myjak@ interia.pl
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