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Griffiths K, Gama RM, Fabian J, Molokhia M. Interpreting an estimated glomerular filtration rate (eGFR) in people of black ethnicities in the UK. BMJ 2023; 380:e073353. [PMID: 36813287 DOI: 10.1136/bmj-2022-073353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Kathryn Griffiths
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Faculty of Life Sciences & Medicine, King's College London, UK
| | - Rouvick Mariano Gama
- King's Kidney Care, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Faculty of Life Sciences & Medicine, King's College London, UK
| | - June Fabian
- Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Mariam Molokhia
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, UK
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Amatruda JG, Katz R, Sarnak MJ, Gutierrez OM, Greenberg JH, Cushman M, Waikar S, Parikh CR, Schelling JR, Jogalekar MP, Bonventre JV, Vasan RS, Kimmel PL, Shlipak MG, Ix JH. Biomarkers of Kidney Tubule Disease and Risk of End-Stage Kidney Disease in Persons With Diabetes and CKD. Kidney Int Rep 2022; 7:1514-1523. [PMID: 35812302 PMCID: PMC9263389 DOI: 10.1016/j.ekir.2022.03.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/18/2022] [Accepted: 03/28/2022] [Indexed: 12/21/2022] Open
Abstract
Introduction Tubulointerstitial damage in diabetes and chronic kidney disease (CKD) is poorly captured by estimated glomerular filtration rate (eGFR) and albuminuria. Urine biomarkers of kidney health may better elucidate disease progression in persons with diabetes and CKD. Methods Per case-cohort design, we randomly selected a subcohort of 560 study participants of the REasons for Geographic And Racial Differences in Stroke (REGARDS) study from 1092 adults with diabetes and baseline eGFR <60 ml/min per 1.73 m2 and registered a total of 161 end-stage kidney disease (ESKD) cases (n = 93 from the subcohort; n = 68 from outside the subcohort) during 4.3 ± 2.7 years mean follow-up. We measured urine biomarkers of kidney tubule injury (kidney injury molecule-1 [KIM-1]), inflammation and fibrosis (monocyte chemoattractant protein-1 [MCP-1]), repair (chitinase-3-like protein 1 [YKL-40]), and tubule function, including reabsorption (alpha-1-microglobulin [α1m]) and synthetic capacity (epidermal growth factor [EGF] and uromodulin [UMOD]). Weighted Cox regression models estimated ESKD risk adjusting for demographics, ESKD risk factors, and baseline eGFR and urine albumin. Least absolute shrinkage and selection operator (LASSO) regression identified a subset of biomarkers most strongly associated with ESKD. Results At baseline, subcohort participants had mean age of 70 ± 9 years, mean eGFR of 40 ±13 ml/min per 1.73 m2, and median urine albumin-to-creatinine ratio of 33 (interquartile range 10-213) mg/g. Adjusting for baseline eGFR and albuminuria, each 2-fold higher urine KIM-1 (hazard ratio = 1.43 [95% CI: 1.17-1.75]), α1m (hazard ratio = 1.47 [1.19-1.82]), and MCP-1 (hazard ratio = 1.27 [1.06-1.53]) were independently associated with ESKD. LASSO retained KIM-1 and α1m for associations with ESKD. Conclusion Among adults with diabetes and eGFR <60 ml/min per 1.73 m2, higher urine KIM-1, α1m, and MCP-1 are independently associated with incident ESKD, providing insight into kidney disease progression in persons with diabetes and CKD.
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Affiliation(s)
- Jonathan G. Amatruda
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Kidney Health Research Collaborative, San Francisco VA Medical Center and University of California, San Francisco, San Francisco, California, USA
| | - Ronit Katz
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
| | - Mark J. Sarnak
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
| | - Orlando M. Gutierrez
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jason H. Greenberg
- Section of Nephrology, Department of Pediatrics, Clinical and Translational Research Accelerator, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Sushrut Waikar
- Section of Nephrology, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Chirag R. Parikh
- Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeffrey R. Schelling
- Division of Nephrology, Department of Internal Medicine, MetroHealth System, Cleveland, Ohio, USA
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Manasi P. Jogalekar
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph V. Bonventre
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ramachandran S. Vasan
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Paul L. Kimmel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Michael G. Shlipak
- Kidney Health Research Collaborative, San Francisco VA Medical Center and University of California, San Francisco, San Francisco, California, USA
- Department of Medicine, San Francisco VA Health Care System, San Francisco, California, USA
| | - Joachim H. Ix
- Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - CKD Biomarkers Consortium
- Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Kidney Health Research Collaborative, San Francisco VA Medical Center and University of California, San Francisco, San Francisco, California, USA
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
- Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Section of Nephrology, Department of Pediatrics, Clinical and Translational Research Accelerator, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
- Section of Nephrology, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
- Division of Nephrology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Nephrology, Department of Internal Medicine, MetroHealth System, Cleveland, Ohio, USA
- Department of Physiology and Biophysics, Case Western Reserve University School of Medicine, Cleveland, Ohio
- Division of Renal Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
- Department of Medicine, San Francisco VA Health Care System, San Francisco, California, USA
- Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
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Fang YJ, Lin KL, Lee JH, Luo KH, Chen TH, Yang CC, Chuang HY. Interaction between Single Nucleotide Polymorphisms (SNP) of Tumor Necrosis Factor-Alpha (TNF-α) Gene and Plasma Arsenic and the Effect on Estimated Glomerular Filtration Rate (eGFR). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074404. [PMID: 35410083 PMCID: PMC8999026 DOI: 10.3390/ijerph19074404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/04/2022]
Abstract
When poisons enter the human body, tumor necrosis factor (TNF-α) will increase and cause damage to tissues through oxidative stress or inflammatory reaction. In previous studies, arsenic (As) has known to cause many health problems. Some studies have shown that As exposure is negatively correlated with estimated glomerular filtration rate (eGFR), or with the prevalence of proteinuria. At present, there are few studies focusing on the effects of As exposure and TNF-α single nucleotide polymorphism (SNP) to eGFR; thus, this study was intended to explore the interactions between TNF-α SNPs and plasma As and their effects on eGFR. A cohort of 500 adults, aged 30 to 70 years, was randomly selected from Taiwan Biobank (TWB). We used the gene chip to screen out seven SNPs of the TNF-α gene and used the results, combined with questionnaires, biochemical tests, and stored plasma samples from the TWB, for the analysis of As by inductively coupled plasma mass spectrometry (ICP-MS). After adjustments for BMI, hypertension, hyperlipidemia, kidney stones, and smoking habits, multiple regression statistics were performed to explore the interaction between SNPs and plasma As with eGFR. In this sample of the general population, plasma As had a significant association with the decline of eGFR (β (SE) = −7.92 (1.70), p < 0.0001). TNF-α gene SNP rs1800629 had the property of regulating TNF-α, which interacts with plasma As; individuals with the AG type had a significantly lower eGFR than those with the GG type, by 9.59 mL/min/1.73 m2 (p < 0.05), which, regarding the dominant model, could infer that the A allele is a risk allele. SNP rs769177 had no interaction with plasma As; however, participants with the TT or TC type had significantly higher eGFR levels than the CC carriers, by 4.02 mL/min/1.73 m2 (p < 0.05). While rs769176 interacted with plasma As, if a person with the TC type had a higher plasma As concentration, that would sustain higher eGFR. This study found that certain SNPs of the TNF-α gene would be robust to the decline of eGFR caused by As exposure. Still, we need further research to confirm the protective regulation mechanism of these SNPs.
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Affiliation(s)
- Yi-Jen Fang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-J.F.); (J.-H.L.)
- Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua 500, Taiwan
| | - Kuan-Lin Lin
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Jyuhn-Hsiarn Lee
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-J.F.); (J.-H.L.)
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County 350, Taiwan
| | - Kuei-Hau Luo
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Tzu-Hua Chen
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Chen-Cheng Yang
- Department of Occupational Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan;
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (Y.-J.F.); (J.-H.L.)
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Department of Public Health and Environmental Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7312-1101
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Samynathan R, Subramanian U, Venkidasamy B, Shariati MA, Chung IM, Thiruvengadam M. S-Allylcysteine (SAC) Exerts Renoprotective Effects via Regulation of TGF-
β1/Smad3 Pathway Mediated Matrix Remodeling in Chronic Renal Failure. Curr Pharm Des 2022; 28:661-670. [DOI: 10.2174/1381612828666220401114301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/03/2021] [Accepted: 04/08/2021] [Indexed: 11/22/2022]
Abstract
Background: S-Allylcysteine (SAC), an organosulfur phytochemical sourced from aged garlic extract,
is well known for its varied biomedical applications, such as anti-oxidant, anti-inflammatory, and detoxification
mechanisms. Despite this, the scientific findings on the defensive impact of SAC against kidney failure
(KF) are still unclear. Therefore, in the current investigation, the animal model of KF was induced by adenine
in Wistar rats, and the animals were divided into four groups as control, KF induction using adenine, SAC treated
KF rats for an experimental duration of 8 weeks.
Methods: KF progression was assessed by various serum and tissue markers, and the results demonstrated that
the renal functions’ markers, KIM-1 (kidney injury molecule-1), cystatin, NGAL (neutrophil gelatinase-associated
lipocalin), were found increased in adenine-treated rats compared to control. In addition, the inflammatory
markers, matrix proteins, and fibrosis signatures explicated by RT-PCR, ELISA demonstrated a profound increase.
On the other hand, rats received SAC mitigated KF considerably (p < 0.001) with restored cellular functions.
Besides, SAC pre-treatment abrogated the cytokines and pro-inflammatory signals (COX-2 and PGE2) in
a dose-dependent manner.
Conclusion: Furthermore, the fibrosis signaling markers mediators, such as SMAD-2,-3 were increased with associated
matrix proteins. Thus, the present study substantiated that SAC possesses a significant renoprotective
effect that might have been demonstrated by the inhibition of the TGF-β1/Smad3 signaling pathway.
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Affiliation(s)
- Ramkumar Samynathan
- Department of Biotechnology, Sri Shakthi Institute of Engineering and Technology, Coimbatore 641062, Tamil Nadu, India
| | - Umadevi Subramanian
- Translational Research Platform for Veterinary Biologicals, Tamil Nadu Veterinary and Animal Sciences University, Madhavaram Milk
Colony, Chennai 600051, Tamil Nadu, India
| | - Baskar Venkidasamy
- Department of Biotechnology, Sri Shakthi Institute of Engineering and Technology, Coimbatore 641062, Tamil Nadu, India
| | - Mohammad Ali Shariati
- Department of Technology of Food Products, K.G. Razumovsky Moscow State University of Technologies and Management (The First Cossack University), 73, Zemlyanoy Val St., Moscow, 109004, Russian Federation
| | - Ill-Min Chung
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Republic of Korea
| | - Muthu Thiruvengadam
- Department of Crop Science, College of Sanghuh Life Science, Konkuk University, Seoul 05029, Republic of Korea
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Thanabalasingam SJ, Iliescu EA, Norman PA, Day AG, Akbari A, Hundemer GL, White CA. Independent External Validation and Comparison of Death and Kidney Replacement Therapy Prediction Models in Advanced CKD. Kidney Med 2022; 4:100440. [PMID: 35445190 PMCID: PMC9014437 DOI: 10.1016/j.xkme.2022.100440] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Rationale & Objective Study Design Setting & Participants Outcomes & Analytical Approach Results Limitations Conclusions
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Affiliation(s)
| | - Eduard A. Iliescu
- Division of Nephrology, Department of Medicine, Queen’s University, Kingston, Canada
| | - Patrick A. Norman
- Kingston General Health Research Institute, Kingston Health Sciences Center, Kingston, Canada
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
| | - Andrew G. Day
- Kingston General Health Research Institute, Kingston Health Sciences Center, Kingston, Canada
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
| | - Ayub Akbari
- Division of Nephrology, Department of Medicine, The University of Ottawa, Ottawa, Canada
| | - Gregory L. Hundemer
- Division of Nephrology, Department of Medicine, The University of Ottawa, Ottawa, Canada
| | - Christine A. White
- Division of Nephrology, Department of Medicine, Queen’s University, Kingston, Canada
- Address for Correspondence: Christine A. White, MD, MSc, Division of Nephrology, Queen’s University, Etherington Hall, 94 Stuart St., Kingston, Ontario, Canada, K7L 3N6.
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Lin CT, Chen TH, Yang CC, Luo KH, Chen TH, Chuang HY. Epidermal Growth Factor Receptor (EGFR) Gene Polymorphism May be a Modifier for Cadmium Kidney Toxicity. Genes (Basel) 2021; 12:genes12101573. [PMID: 34680968 PMCID: PMC8535213 DOI: 10.3390/genes12101573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/25/2021] [Accepted: 10/01/2021] [Indexed: 11/16/2022] Open
Abstract
The results of many studies indicate that cadmium (Cd) exposure is harmful to humans, with the proximal tubule of the kidney being the main target of Cd accumulation and toxicity. Studies have also shown that Cd has the effect of activating the pathway of epidermal growth factor receptor (EGFR) signaling and cell growth. The EGFR is a family of transmembrane receptors, which are widely expressed in the human kidney. The aim of this study was to investigate the kidney function estimated glomerular filtration rate (eGFR), and its relationship with plasma Cd level and EGFR gene polymorphism. Using data from Academia Sinica Taiwan biobank, 489 subjects aged 30-70 years were analyzed. The demographic characteristics was determined from questionnaires, and biological sampling of urine and blood was determined from physical examination. Kidney function was assessed by the eGFR with CKD-EPI formula. Plasma Cd (ug/L) was measured by inductively coupled plasma mass spectrometry. A total of 97 single-nucleotide polymorphisms (SNPs) were identified in the EGFR on the Taiwan biobank chip, however 4 SNPs did not pass the quality control. Multiple regression analyses were performed to achieve the study aim. The mean (±SD) plasma Cd level of the study subjects was 0.02 (±0.008) ug/L. After adjusting for confounding variables, rs13244925 AA, rs6948867 AA, rs35891645 TT and rs6593214 AA types had higher eGFR (4.89 mL/min/1.73 m2 (p = 0.035), 5.54 mL/min/1.73 m2 (p = 0.03), 4.96 mL/min/1.73 m2 (p = 0.048) and 5.16 mL/min/1.73 m2 (p = 0.048), respectively). Plasma cadmium and rs845555 had an interactive effect on eGFR. In conclusion, EGFR polymorphisms could be modifiers of Cd kidney toxicity, in which rs13244925 AA, rs6948867 AA, rs35891645 TT and rs6593214 AA may be protective, and Cd interacting with rs845555 may affect kidney function.
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Affiliation(s)
- Chun-Ting Lin
- Department of Public, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.L.); (T.-H.C.)
| | - Ting-Hao Chen
- Department of Public, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan; (C.-T.L.); (T.-H.C.)
| | - Chen-Cheng Yang
- Departments of Occupational Medicine and Family Medicine, Kaohsiung Municipal Siaogang Hospital, and Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Kuei-Hau Luo
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Tzu-Hua Chen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, and Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Hung-Yi Chuang
- Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Department of Public Health and Environmental Medicine, College of Medicine, and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7312-1101 (ext. 6849)
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Li X, Su T, Xiao H, Gao P, Xiong C, Liu J, Zou H. Association of the HDL-c Level with HsCRP, IL-6, U-NAG, RBP and Cys-C in Type 2 Diabetes Mellitus, Hypertension, and Chronic Kidney Disease: An Epidemiological Survey. Diabetes Metab Syndr Obes 2020; 13:3645-3654. [PMID: 33116716 PMCID: PMC7568590 DOI: 10.2147/dmso.s265735] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/10/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To explore the association between the anti-inflammatory and renal protective roles of high-density lipoprotein cholesterol (HDL-c) and its different levels in type 2 diabetes mellitus (T2D), hypertension (HTN), and chronic kidney disease (CKD) and to lay a theoretical basis for precise, maximum-benefit HDL-c-raising therapy for patients with these diseases. PATIENTS AND METHODS A total of 2127 participants (195 with T2D, 618 with HTN, 162 with CKD, and 1152 controls) were selected and divided into four groups according to their baseline HDL-c level, namely, low HDL-c (L-HDL-c, ≤1.03 mmol/L), medium HDL-c (M-HDL-c, 1.04-1.55 mmol/L), high HDL-c (H-HDL-c, 1.56-2.05 mmol/L) and extremely high HDL-c (E-HDL-c, ≥ 2.06 mmol/L). Serum and morning urine samples were collected to analyze the correlation between high-sensitivity C-reactive protein (HsCRP), interleukin-6 (IL-6), urine n-acetyl-β-d-glucosidase (U-NAG), retinol binding protein (RBP), and cystatin c (Cys-C) levels with the HDL-c levels. RESULTS The HDL-c levels of patients with T2D, HTN and CKD were universally lower than those in the control group in both sexes (p<0.05), while male patients also manifested a lower level of HDL-c than female patients. However, although they had lower values of the renal impairment index, female patients were found to have anomalously higher amounts of proinflammatory cytokines. In addition, the correlations between HsCRP and RBP levels and HDL-c levels were most significant in patients with HTN (p<0.05), whereas in patients with T2D and CKD, such relevance was less significant. CONCLUSION Existence of substantial differences in HDL-c levels between different types of disease and sex highlighted that a higher HDL level does not always predict a better clinical outcome of patients. Moreover, we found that both HsCRP and RBP correlated negatively with HDL-c in HTN patients, indicating that monitoring HsCRP and RBP may serve as indicators for therapeutic efficacy of HDL-c-raising medications in HTN patients.
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Affiliation(s)
- Xiaolin Li
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Department of Endocrinology, Hunan University of Medicine, Huaihua 418000, Hunan, People’s Republic of China
| | - Ting Su
- Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of China
| | - Hua Xiao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Peichun Gao
- School of Public Health, Southern Medical University, Guangzhou510080, People’s Republic of China
| | - Chongxiang Xiong
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Jinghua Liu
- Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of China
- Correspondence: Jinghua Liu Guangdong Provincial Key Laboratory of Proteomics, School of Basic Medical Sciences, Southern Medical University, Guangzhou510515, People’s Republic of ChinaTel +86 20 61648392Fax +86 20 61648231 Email
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Hequn ZouDepartment of Nephrology, The Third Affiliated Hospital, Southern Medical University, 183 Zhongshan Dadao, Tianhe District, Guangzhou510630, People’s Republic of ChinaTel +86 20 62784393Fax +86 20 62784399 Email
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Bon H, Hales P, Lumb S, Holdsworth G, Johnson T, Qureshi O, Twomey BM. Spontaneous Extracellular Matrix Accumulation in a Human in vitro Model of Renal Fibrosis Is Mediated by αV Integrins. Nephron Clin Pract 2019; 142:328-350. [PMID: 31048591 DOI: 10.1159/000499506] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/10/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Tubulointerstitial fibrosis is a key feature of chronic kidney diseases leading to renal failure. It is characterised by the infiltration of fibroblasts and aberrant accumulation of extracellular matrix (ECM) proteins, which are associated with progressive loss of renal function. Integrins play a major role in fibrosis, but the mechanisms through which they do this are not fully understood. OBJECTIVE Using a complex cell system, we test the hypothesis that integrins are pro-fibrotic via regulation of functional interactions between tubular epithelial cells and renal fibroblasts. METHOD Contact co-culture of human primary renal proximal tubular epithelial cells and renal fibroblasts promoted the spontaneous accumulation of a mature ECM rich in interstitial collagens, which was considerably in excess of that seen in the individual mono-cultures. Both cell types persisted throughout the culture and were capable of expressing multiple ECM components. RESULTS While ECM accumulation was inhibited by the clinically proven anti-fibrotic, nintedanib, and was partially abrogated by transforming growth factor β neutralisation, its levels did not return to basal, indicating additional pathways were implicated in the pro-ECM response. Application of anti-integrin blocking antibodies and small molecules demonstrated a major role of the αV integrins in the ECM accumulation during fibroblast: epithelial cell interactions. CONCLUSION Integrin-mediated pathways can facilitate the spontaneous accumulation of ECM during fibroblast: epithelial cell interactions, and this direct renal co-culture assay system could provide a translational in vitro assay for investigating novel pathways involved in the pro-ECM response and the screening of renal anti-fibrotic agents.
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Yamakado S, Cho H, Inada M, Morikawa M, Jiang YH, Saito K, Nakaishi K, Watabe S, Takagi H, Kaneda M, Nakatsuma A, Ninomiya M, Imachi H, Arai T, Yoshimoto T, Murao K, Chang JH, Chen SM, Shih YC, Zeng MJ, Ke LY, Chen CH, Yoshimura T, Miura T, Ito E. Urinary adiponectin as a new diagnostic index for chronic kidney disease due to diabetic nephropathy. BMJ Open Diabetes Res Care 2019; 7:e000661. [PMID: 31245009 PMCID: PMC6557464 DOI: 10.1136/bmjdrc-2019-000661] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/18/2019] [Accepted: 05/03/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The chronic kidney disease (CKD) is widely diagnosed on the basis of albuminuria and the glomerular filtration rate. A more precise diagnosis of CKD, however, requires the assessment of other factors. Urinary adiponectin recently attracted attention for CKD assessment, but evaluation is difficult due to the very low concentration of urinary adiponectin in normal subjects. RESEARCH DESIGN AND METHODS We developed an ultrasensitive ELISA coupled with thionicotinamide-adenine dinucleotide cycling to detect trace amounts of proteins, which allows us to measure urinary adiponectin at the subattomole level. We measured urinary adiponectin levels in 59 patients with diabetes mellitus (DM) and 24 subjects without DM (normal) to test our hypothesis that urinary adiponectin levels increase with progression of CKD due to DM. RESULTS The urinary adiponectin levels were 14.88±3.16 (ng/mg creatinine, mean±SEM) for patients with DM, and 3.06±0.33 (ng/mg creatinine) for normal subjects. The threshold between them was 4.0 ng/mg creatinine. The urinary adiponectin levels increased with an increase in the CKD risk. Furthermore, urinary adiponectin mainly formed a medium-molecular weight multimer (a hexamer) in patients with DM, whereas it formed only a low-molecular weight multimer (a trimer) in normal subjects. That is, the increase in urinary adiponectin in patients with DM led to the emergence of a medium-molecular weight form in urine. CONCLUSIONS Our new assay showed that urinary adiponectin could be a new diagnostic index for CKD. This assay is a non-invasive test using only urine, thus reducing the patient burden.
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Affiliation(s)
| | - Hiroki Cho
- Department of Biology, Waseda University, Shinjuku, Tokyo, Japan
| | - Mikio Inada
- Department of Biology, Waseda University, Shinjuku, Tokyo, Japan
| | - Mika Morikawa
- R&D Headquarters, TAUNS Laboratories, Izunokuni, Shizuoka, Japan
| | - Yong-Huang Jiang
- R&D Headquarters, TAUNS Laboratories, Izunokuni, Shizuoka, Japan
| | - Kenji Saito
- R&D Headquarters, TAUNS Laboratories, Izunokuni, Shizuoka, Japan
| | | | - Satoshi Watabe
- R&D Headquarters, TAUNS Laboratories, Izunokuni, Shizuoka, Japan
| | - Hitomi Takagi
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Kagawa, Japan
| | - Mugiho Kaneda
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Kagawa, Japan
| | - Akira Nakatsuma
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Kagawa, Japan
| | - Masaki Ninomiya
- Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, Sanuki, Kagawa, Japan
| | - Hitomi Imachi
- Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan
| | - Takeshi Arai
- Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan
| | | | - Koji Murao
- Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan
| | - Jyun-Hao Chang
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Min Chen
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chen Shih
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Min-Jing Zeng
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Liang-Yin Ke
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chu-Huang Chen
- Lipid Science and Aging Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Teruki Yoshimura
- Faculty of Pharmaceutical Sciences, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Toshiaki Miura
- Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Etsuro Ito
- Department of Biology, Waseda University, Shinjuku, Tokyo, Japan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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10
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Turolo S, Edefonti A, Syren ML, Marangoni F, Morello W, Agostoni C, Montini G. Fatty Acids in Nephrotic Syndrome and Chronic Kidney Disease. J Ren Nutr 2017; 28:145-155. [PMID: 29153556 DOI: 10.1053/j.jrn.2017.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 12/14/2022] Open
Abstract
The role of fatty acids (FAs) in inflammation and in the related chronic diseases has been demonstrated. However, there is a lack of consistent and agreed knowledge about the role of FA profile and renal physiology and pathology, most articles focusing on the effect of polyunsaturated FAs supplementation, without considering the impact of basal FA metabolism on the efficacy of the supplementation. Here, we have summarized the specific literature concerning the assessment of circulating FA in 2 renal diseases, namely nephrotic syndrome and chronic kidney disease, also under hemodialytic treatment, and have received the most significant contributions in the last years. The effects of changes of FA profile and metabolism and the possible involvement of polyunsaturated FA metabolites in raising and modulating inflammation are discussed.
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Affiliation(s)
- Stefano Turolo
- Pediatric Department of Nephrology Dialysis and Transplantation, IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Alberto Edefonti
- Pediatric Department of Nephrology Dialysis and Transplantation, IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marie Louise Syren
- Pediatric Clinic IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - William Morello
- Pediatric Department of Nephrology Dialysis and Transplantation, IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Pediatric Clinic IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giovanni Montini
- Pediatric Department of Nephrology Dialysis and Transplantation, IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Pediatric Clinic IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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11
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Anuwatmatee S, Tang S, Wu BJ, Rye KA, Ong KL. Fibroblast growth factor 21 in chronic kidney disease. Clin Chim Acta 2017; 489:196-202. [PMID: 29108880 DOI: 10.1016/j.cca.2017.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 11/01/2017] [Accepted: 11/02/2017] [Indexed: 12/17/2022]
Abstract
The association between fibroblast growth factor 21 (FGF21) and kidney function has been extensively studied in recent years in both animal and human studies. However, the exact functional role of FGF21 in the kidney remains unclear. Previous animal studies have shown that administration of FGF21 ameliorates kidney function, morphological glomerular abnormalities, dyslipidemia, hyperglycemia, insulin resistance, oxidative stress and obesity. In human studies, FGF21 levels negatively correlated with estimated glomerular filtration rate. FGF21 levels were elevated in patients with end-stage renal disease. The elevation of FGF21 levels in presence of kidney disease has also raised questions as to whether FGF21 is a potential biomarker for detecting a decline in renal function. In recent clinical trials, an FGF21 analogue reduced insulin levels and body weight, and ameliorated dyslipidemia in patients with type 2 diabetes mellitus and obesity, all of which are well-known risk factors for kidney disease. Thus, FGF21 may be a potential therapeutic target for the treatment of kidney disease, although adverse side effects should also be considered when administering FGF21 since FGF21 may affect bone development and reproduction. This review will assess current knowledge on the relationship between FGF21 and kidney function.
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Affiliation(s)
| | - Shudi Tang
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Ben J Wu
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Kerry-Anne Rye
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Kwok Leung Ong
- School of Medical Sciences, UNSW Australia, Sydney, NSW, Australia.
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