Assessment of urinary podocalyxin as a marker of glomerular injury in obesity‐related kidney disease in children and adolescents with obesity compared to urinary albumin creatinine ratio

2021 ◽  
Author(s):  
Noha Musa ◽  
Tarek Ramzy ◽  
Ahmed Hamdy ◽  
Noha Arafa ◽  
Mona Hassan
Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yusuke Tanigaito ◽  
Kayoko Sato ◽  
Kazutaka Kitamura ◽  
Atsuko Futase ◽  
Keiko Fukushima ◽  
...  

Introduction: Recent studies suggested that the atherogenic state correlated with progression of chronic kidney disease (CKD). However, it is not known whether sustained status of chronic inflammation in atherosclerosis is closely linked to the development of CKD. Hypothesis: Inflammatory cytokine producing-T cells in the advanced atherosclerosis induced the dysfunction of podocytes. Methods/Results: Eighteen-week-old apolipoprotein E-deficient mice (Control) were fed with high-fat diet for 8W (ApoE) and compared to IL17/ApoE-double deficient mice fed with high-fat diet (DKO). Sudan staining of aorta revealed the atherosclerotic lesion was increased in ApoE compared to Control, and inhibited in DKO. Activated IFNγ + CD4 T cells (Th1) and IL17 + CD4 T cells (Th17) were significantly increased in ApoE compared to DKO by FACS. Immunohistochemistry of aortic sinus showed many Th1 and Th17 were infiltrated in the atherosclerotic plaque in ApoE, however, inflammatory infiltrates were inhibited in DKO. Furthermore, the urinary albumin/creatinine ratio was increased significantly in ApoE compared to DKO. Th1 and Th17 were correlated with the urinary albumin/creatinine ratio, and many Th1 and Th17 were observed in the glomeruli. Next, to investigate whether the inflammatory cytokine induced dysfunction of podocytes were involved in proteinuria, we investigated nephrin, podocin, and phosphorylated nephrin in the kidney by Western blots and immunohistochemistry. The decreased phosphorylated neprin in ApoE were recovered in DKO. Finally, we confirmed that the morphological changed of podocytes in ApoE were improved in DKO by electron microscopy. Conclusion: Recruitments of IFNγ + Th1 and IL17 + Th17 T cells might aggravate atherosclerosis acceleration and induce the initiation of glomerular tissue damage.


Author(s):  
Melek Cihanbeylerden ◽  
Melike Bağnu Yüceege

Abstract Introduction Obstructive sleep apnoea (OSA) is a cause of hypoxia, and the correlation between hypoxia and microvascular complications is well known. Microalbuminuria (MAU) is a marker for endovascular dysfunction and an indicator of cardiovascular events and all-cause mortality in the general population. The aim of this study was to investigate the relationship between microvascular damage and the metabolic complications of OSA based on the presence of MAU. Material and method Urinary albumin/creatinine ratio (ACR) and microalbumin level were examined in patients with an apnoea-hypopnoea index (AHI) greater than 5/h (study group) and in patients with an AHI less than 5/h (control group). The exclusion criteria were other possible causes of MAU (hypertension, nephropathy, coronary artery disease, and severe thyroid dysfunction). Results Of 103 patients enrolled, 80 formed the group with OSA and 23 served as controls. According to the AHI values, the patients were divided into four groups as normal, mild, moderate and severe. There was no significant difference between the four groups in terms of the microalbumin level and urinary albumin/creatinine ratio. Conclusion In this study, no significant relationship was found between MAU and sleep apnoea.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040214
Author(s):  
Shan Qin ◽  
Anping Wang ◽  
Shi Gu ◽  
Weiqing Wang ◽  
Zhengnan Gao ◽  
...  

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.


2021 ◽  
Author(s):  
Wanlu Su ◽  
Jie Wang ◽  
Songyan Yu ◽  
Kang Chen ◽  
Wenhua Yan ◽  
...  

Abstract BackgroundThe metabolic score for insulin resistance (METS-IR) is a novel noninsulin-based metabolic index used as a substitution marker of insulin resistance. However, whether METS-IR is associated with the urinary albumin–creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS-IR and UACR and compared the discriminative ability of METS-IR and its components for elevated UACR. MethodsThis study included 37,290 subjects. METS-IR was calculated as follows: (Ln [2 × fasting blood glucose (FBG) + fasting triglyceride level (TG 0 )] × body mass index (BMI))/[Ln (high-density lipoprotein cholesterol (HDL-C))]. Participants were divided into four groups on the basis of METS-IR: <25%, 25%–49%, 50%–74%, and ≥75%. Logistic regression analyses were conducted to determine the associations between METS-IR vs. its components (FBG, TG 0 , BMI, and HDL-C) with UACR. ResultsParticipants with the highest quartile METS-IR presented a more significant trend towards elevated UACR than towards its components (odds ratio [OR]: 1.260, 95% CI: 1.152–1.378, P < 0.001 in all subjects; OR: 1.321, 95% CI: 1.104–1.579, P = 0.002 in men; OR: 1.201, 95% CI: 1.083–1.330, P < 0.001 in women). There were significant associations between METS-IR and UACR in younger participants (<65 years for women and 55–64 years for men). Increased METS-IR was significantly associated with UACR in men with FBG ≥ 5.6 mmol/L or postprandial blood glucose ≥ 7.8 mmol/L and systolic blood pressure ≥ 120 mmHg or diastolic blood pressure ≥ 80 mmHg. The relationships were significant in women with diabetes and hypertension.ConclusionsIncreased METS-IR was significantly associated with elevated UACR, and its discriminative power for elevated UACR was superior to that of its components. This findings support the clinical significance of METS-IR for evaluating renal function damage.


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