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Urinary uromodulin and collagen IV complex reflects the severity of renal impairment in chronic glomerulonephritis patientsтезисы доклада
Информация о цитировании статьи получена из
Web of Science
Дата последнего поиска статьи во внешних источниках: 20 мая 2017 г.
- Авторы: Mikhail Shvetsov, Zheng Antai, Lidia Kozlovskaya, Anna Serova, Nikolay Mukhin
- Сборник: Nephrology Dialysis Transplantation
- Серия: Suppl 1
- Том: 31
- Тезисы
- Год издания: 2016
- Издательство: Oxford University Press
- Местоположение издательства: United Kingdom
- Первая страница: 38
- Последняя страница: 39
- Аннотация: Abstract: INTRODUCTION AND AIMS: Although it is well proven that tubulointerstitial fibrosis (TIF) plays an important role in progression of chronic glomerulonephritis (CGN), there are no approaches for TIF monitoring in clinical practice for more precise control of the immunosuppressive and renoprotective treatment effectiveness. Uromoduline (UMOD) is a transmembrane glycoprotein produced by the thick ascending limb of the loop of Henle. As the most abundant protein excreted in normal human urine and highly specific for renal tubulocytes UMOD can be considered the candidate for urinary biomarker of TIF progression. The aim of the study was to investigate the urinary excretion of UMOD and collagen IV (COL4) in patients with CGN, its possible associations with proteinuria (PU) and other clinical signs of CGN activity, glomerular filtration rate, morphologic degree of nephrosclerosis. METHODS: 82 CGN patients (45% men, 55% women; mean age 36.5 (28.0; 55.0)) were examined. 69,5% patients developed arterial hypertension; in 31.7% of the study patients the hypertension was sever or resistant (blood pressure (BP) ≥ 160/100 Hg mm before treatment or BP ≥ 140/90 Hg mm although 3 or more antihypertensive drugs are used). Nephrotic syndrome was revealed in 31.7%; glomerular filtration rate estimated using the CKD-EPI formula (eGFR) < 60 ml/min/1.73 m2 was found in 31.7% of the study patients. High degree of interstitial fibrosis (> 30%) was found in 38.2% patients. Morning urine samples were analyzed by ELISA to determine the excretion of biomarkers (UMOD and COL4). The results were adjusted to urinary creatinine concentrations. RESULTS: Urinary excretion of COL4 positively correlated with age (Rs = 0.39; p < 0.001), CKD duration (Rs = 0.25; p < 0.05), systolic and diastolic blood pressure (Rs = 0.22; p < 0,05 and Rs = 0.25; p < 0.05), PU (Rs = 0,50; p < 0,0001), serum fibrinogen (Rs = 0.57; p < 0.0001), and negatively correlated with eGFR (Rs = -0.36; p < 0.001), hemoglobin (Rs = - 0.32; p < 0.01). In contrast urinary excretion of UMOD only positively correlated with eGFR (Rs = 0.37; p < 0.001), and negatively correlated with CKD duration (Rs = -0.43; p < 0.0001). High UMOD excretion (> 75th percentile) was although in group with high degree of interstitial fibrosis nobody presented high level of UMOD. Clinical and laboratory pattern of CGN patients stratified by urinary excretion of UMOD and COL4 Urinary UMOD / COL4 Older age PU ≥ 0.5 g/d Nephrotic syndrome Severe arterial hypertension eGFR < 60 ml/min/ 1.73 m2 Anemia High UMOD / not high COL4, n = 15 13.3% 46.7% 26.7% 13.3% 13.3% 13.3% High UMOD / high COL4, n =5 40.0% 80.0% 60.0% 20.0% 0.0% 0.0% Not high UMOD / not high COL4, n = 44 18.2% 72.7% 22.7% 29.6% 31.8% 15.9% Not high UMOD 62.5% 100.0% 56.3% 56.3% 62.5% 62.5% / high COL4, n = 16 χ2 = 13.65; р < 0.01 χ2 = 11.50; р < 0.01 χ2 = 7.99; р < 0.05 χ2 = 7.25; 0.05 ≤ р < 0.1 χ2 = 11.49; р < 0.01 χ2 = 15.76; р < 0.001 CONCLUSIONS: While COL4 excretion can be considered the universal biomarker signing both CGN activity and progression, UMOD excretion is exclusively associated with nephrosclerosis development. The combination of high COL4 and depleted UMOD excretion was found in the most sever cases of CGN; this combination can reflect tubulocytes transdifferentiation and apoptosis. Studying UMOD and COL4 urinary excretion complex can be useful for estimation of CGN stage and prognosis. But prospective studies are needed to verify it.
- Добавил в систему: Георгинова Ольга Анатольевна