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Noiri E, Katagiri D, Asai Y, Sugaya T, Tokunaga K. Urine oxygenation predicts COVID-19 risk. Clin Exp Nephrol 2024; 28:608-616. [PMID: 38400935 PMCID: PMC11189954 DOI: 10.1007/s10157-023-02456-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/28/2023] [Indexed: 02/26/2024]
Abstract
Since February, 2023, the omicron variant has accounted for essentially all new coronavirus infections in Japan. If future infections involve mutant strains with the same level of infectivity and virulence as omicron, the government's basic policy will be to prevent the spread of infection, without compromising socioeconomic activities. Objectives include protecting pregnant women and elderly persons, and focusing on citizens requiring hospitalization and those at risk of serious illness, without imposing new social restrictions. Although the government tries to raise public awareness through education, most people affected by COVID-19 stay at home, and by the time patients become aware of the seriousness of their disease, it has often reached moderate or higher severity. In this review, we discuss why this situation persists even though the disease seems to have become milder with the shift from the delta variant to omicron. We also propose a pathophysiological method to determine the risk of severe illness. This assessment can be made at home in the early stages of COVID-19 infection, using urine analysis. Applicability of this method to drug discovery and development is also discussed.
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Affiliation(s)
- Eisei Noiri
- National Center Biobank Network (NCBN), Central Biobank, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Daisuke Katagiri
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- Antimicrobial Resistance Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine (NCGM), Tokyo, Japan
| | | | - Katsushi Tokunaga
- National Center Biobank Network (NCBN), Central Biobank, National Center for Global Health and Medicine (NCGM), 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan
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Naruse H, Ishii J, Takahashi H, Kitagawa F, Nishimura H, Kawai H, Muramatsu T, Harada M, Yamada A, Fujiwara W, Hayashi M, Motoyama S, Sarai M, Watanabe E, Izawa H, Ozaki Y. Urinary Liver-Type Fatty-Acid-Binding Protein Predicts Long-Term Adverse Outcomes in Medical Cardiac Intensive Care Units. J Clin Med 2020; 9:jcm9020482. [PMID: 32050627 PMCID: PMC7073895 DOI: 10.3390/jcm9020482] [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: 01/20/2020] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
We prospectively investigated the prognostic value of urinary liver-type fatty-acid-binding protein (L-FABP) levels on hospital admission, both independently and in combination with serum creatinine-defined acute kidney injury (AKI), to predict long-term adverse outcomes in 1119 heterogeneous patients (mean age; 68 years) treated at medical (non-surgical) cardiac intensive care units (CICUs). Patients with stage 5 chronic kidney disease were excluded from the study. Of these patients, 47% had acute coronary syndrome and 38% had acute decompensated heart failure. The creatinine-defined AKI was diagnosed according to the "Kidney Disease: Improving Global Outcomes" criteria. The primary endpoint was a composite of all-cause death or progression to end-stage kidney disease, indicating the initiation of maintenance dialysis therapy or kidney transplantation. Creatinine-defined AKI occurred in 207 patients, with 44 patients having stage 2 or 3 disease. During a mean follow-up period of 41 months after enrollment, the primary endpoint occurred in 242 patients. Multivariate Cox regression analyses revealed L-FABP levels as independent predictors of the primary endpoint (p < 0.001). Adding L-FABP to a baseline model with established risk factors further enhanced reclassification and discrimination beyond that of the baseline model alone, for primary-endpoint prediction (both; p < 0.01). On Kaplan-Meier analyses, increased L-FABP (≥4th quintile value of 9.0 ng/mL) on admission or presence of creatinine-defined AKI, correlated with an increased risk of the primary endpoint (p < 0.001). Thus, urinary L-FABP levels on admission are potent and independent predictors of long-term adverse outcomes, and they might improve the long-term risk stratification of patients admitted at medical CICUs, when used in combination with creatinine-defined AKI.
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Affiliation(s)
- Hiroyuki Naruse
- Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (F.K.)
| | - Junnichi Ishii
- Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (F.K.)
- Correspondence: ; Tel.: +81-562-93-2312
| | - Hiroshi Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake 470-1192, Japan;
| | - Fumihiko Kitagawa
- Department of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (F.K.)
| | - Hideto Nishimura
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Hideki Kawai
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Takashi Muramatsu
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Masahide Harada
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Akira Yamada
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Wakaya Fujiwara
- Department of Cardiology, Bantane Hospital, Nagoya 454-8509, Japan; (W.F.); (M.H.); (H.I.)
| | - Mutsuharu Hayashi
- Department of Cardiology, Bantane Hospital, Nagoya 454-8509, Japan; (W.F.); (M.H.); (H.I.)
| | - Sadako Motoyama
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Masayoshi Sarai
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Eiichi Watanabe
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
| | - Hideo Izawa
- Department of Cardiology, Bantane Hospital, Nagoya 454-8509, Japan; (W.F.); (M.H.); (H.I.)
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan (H.K.); (T.M.); (M.H.); (A.Y.); (S.M.); (M.S.); (E.W.)
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Hashimoto T, Fang YI, Ohata H, Honda K. Change in soluble epoxide hydrolase (sEH) during cisplatin-induced acute renal failure in mice. J Toxicol Sci 2016; 40:451-7. [PMID: 26165641 DOI: 10.2131/jts.40.451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Cisplatin is one of the most effective chemotherapeutic agents against various types of cancers; however, it is also associated with nephrotoxicity. Recently, it was reported that inflammatory mechanisms play a key role in the development of nephrotoxicity. Epoxyeicosatrienoic acids (EETs) have an anti-inflammatory effect and are metabolized by soluble epoxide hydrolase (sEH: encoded by EPHX2 gene). Here, we determined the change in sEH activity and EPHX2 expression in renal tissue associated with the development of cisplatin-induced nephrotoxicity. Cisplatin administration decreased hydrolase activity accompanied by down-regulation of sEH and EPHX2 expression. The down-regulation occurred prior to the elevation of blood urea nitrogen (BUN) and tumor necrosis factor-α (TNF-α) gene expression or at treatment with low dose cisplatin. In addition, a negative correlation was found between EPHX2 expression and renal thiobarbituric acid reactive substance (TBARS), and edaravone, a radical scavenger, administration did not down-regulate expression of this gene. The results of this study suggest that cisplatin decreased sEH activity through the down-regulation of sEH and EPHX2 expression, and this down-regulation was involved in a negative feedback loop to protect renal tissue from further damage. Thus, sEH is a potential therapeutic target of cisplatin-induced nephrotoxicity.
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Affiliation(s)
- Terumasa Hashimoto
- Division of Pharmacology, Department of Pharmacology, Toxicology & Therapeutics, School of Pharmacy, Showa University
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Chaudhary K, Phadke G, Nistala R, Weidmeyer CE, McFarlane SI, Whaley-Connell A. The emerging role of biomarkers in diabetic and hypertensive chronic kidney disease. Curr Diab Rep 2010; 10:37-42. [PMID: 20425065 DOI: 10.1007/s11892-009-0080-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Currently used measures to assess kidney function and injury are largely inadequate. Markers such as serum creatinine, formulas to estimate glomerular filtration rate, cystatin C, and proteinuria largely identify an underlying disease process that is well established. Thus, there has been a recent effort to identify new biomarkers that reflect kidney function, early injury, and/or repair that ultimately can relate to progression or regression of damage. Several biomarkers emerged recently that are able to detect kidney damage earlier than is currently possible with traditional biomarkers such as serum creatinine and proteinuria. Identification of urine biomarkers has proven to be beneficial in recent years because of ease of handling, stability, and the ability to standardize the various markers to creatinine or other peptides generally already present in the urine. Recent markers such as neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and podocin have garnered a lot of attention. The emergence of these and other biomarkers is largely because of the evolution of novel genomic and proteomic applications in investigations of acute kidney injury and chronic kidney disease. In this article, we focus on the applications of these biomarkers in disease.
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Affiliation(s)
- Kunal Chaudhary
- Department of Internal Medicine, Division of Nephrology and Hypertension, University of Missouri-Columbia School of Medicine, CE417, DC043.0, Five Hospital Drive, Columbia, MO 65212, USA
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