Serum-to-urine renalase ratio and its differences between healthy adults and chronic kidney disease patients

Abstract Background: Renalase is a flavoprotein that plays a protective role in chronic kidney disease and cardiovascular diseases. The secretion and way of action of this protein are still discussed. The aim of our study was to estimate the balance between serum and urine renalase in healthy individuals and chronic kidney disease (CKD) patients, using two parameters: fractional excretion (FE) and serum-to-urine renalase ratio (StURR). Methods: Our study involved 28 healthy volunteers and 62 patients with CKD in stages I to IV. The concentration of renalase in serum and urine was measured using an enzyme-linked immunosorbent assay (ELISA) kit (EIAab, Wuhan, China). We analyzed associations between renalase levels in urine and serum, and other parameters: sex, age, GFR, presence of hypertension, diabetes, and proteinuria, and determined the serum-to-urine renalase ratio and fractional excretion of renalase. Results: Renalase and serum-to-urine ratio were significantly higher in CKD patients in comparison with the control group. Fractional excretion was lower in CKD patients but this difference did not reach the statistical significance (p=0.092). Multivariate analysis performed in the CKD group showed, that from mentioned parameters, serum renalase was the only significant independent factor strongly positively associated with urinary renalase concentration. Conclusions: The serum-to-urine ratio is significantly and about 6.5-fold higher in CKD patients, and the fractional excretion of renalase is 3-fold, but not significantly lower in CKD patients. Renalase levels in both serum and urine are not related to glomerular filtration rate and not associated with blood pressure.

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Serum-to-urine renalase ratio and renalase fractional excretion in healthy adults and chronic kidney disease patients.

10.21203/rs.2.13025/v4 ◽

2020 ◽

Author(s):

Natalia Maria Serwin ◽

Magda Wiśniewska ◽

Elżbieta Cecerska-Heryć ◽

Krzysztof Safranow ◽

Edyta Skwirczyńska ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Statistical Significance ◽

Fractional Excretion ◽

Protective Role ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Significant Independent Factor ◽

Two Parameters ◽

Serum And Urine

Abstract Background: Renalase is a flavoprotein that plays a protective role in chronic kidney disease (CKD) and cardiovascular diseases. The secretion and way of action of this protein are still discussed. The aim of our study was to estimate the balance between serum and urine renalase in healthy individuals and CKD patients, using two parameters: fractional excretion (FE) and serum-to-urine renalase ratio (StURR). Methods: Our study involved 28 healthy volunteers and 62 patients with CKD in stages I to IV. The concentration of renalase in serum and urine was measured using an enzyme-linked immunosorbent assay (ELISA) kit (EIAab, Wuhan, China). We analyzed associations between renalase levels in urine and serum, and other parameters: sex, age, GFR, presence of hypertension, diabetes, and proteinuria, and determined the serum-to-urine renalase ratio and fractional excretion of renalase. Results: Renalase and serum-to-urine ratio were significantly higher in CKD patients in comparison with the control group. Fractional excretion was lower in CKD patients but this difference did not reach the statistical significance (p=0.092). Multivariate analysis performed in the CKD group showed, that from mentioned parameters, serum renalase was the only significant independent factor strongly positively associated with urinary renalase concentration. Conclusions: The serum-to-urine ratio is significantly and about 6.5-fold higher in CKD patients, and the fractional excretion of renalase is 3-fold, but not significantly lower in CKD patients. Renalase levels in both serum and urine are not related to glomerular filtration rate and not associated with blood pressure.

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Serum-to-urine renalase ratio and renalase fractional excretion in healthy adults and chronic kidney disease patients.

10.21203/rs.2.13025/v3 ◽

2019 ◽

Author(s):

Natalia Maria Serwin ◽

Magda Wiśniewska ◽

Elżbieta Cecerska-Heryć ◽

Krzysztof Safranow ◽

Edyta Skwirczyńska ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Statistical Significance ◽

Fractional Excretion ◽

Protective Role ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Significant Independent Factor ◽

Two Parameters ◽

Serum And Urine

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Serum-to-urine renalase ratio and its differences between healthy adults and chronic kidney disease patients

10.21203/rs.2.13025/v1 ◽

2019 ◽

Author(s):

Natalia Maria Serwin ◽

Magda Wiśniewska ◽

Elżbieta Cecerska-Heryć ◽

Krzysztof Safranow ◽

Edyta Skwirczyńska ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Potential Role ◽

Circulatory System ◽

Healthy Adults ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Test Results ◽

Serum And Urine

Abstract Background Renalase is a flavoprotein involved in pathomechanisms of chronic kidney disease and heart and circulatory system disorders. Secretion and way of action of this protein are still discussed. Aim of our study was to initially estimate the balance between serum and urine renalase in healthy adults and to compare obtained ratio to chronic kidney disease patients. Methods Our study involved 28 healthy volunteers and 62 patients with diagnosed chronic kidney disease in stages I to IV. Concentration of renalase in blood serum and urine was measured using enzyme-linked immunosorbent assay (ELISA) kit (Uscn Life Science, Wuhan, China). We analyzed serum-to-urine renalase proportion in both groups and evaluated the differences using Mann Whitney U-test. Results Renalase serum-to-urine ratio was significantly higher in chronic kidney disease patients in comparison with control group (1.146 and 0.177, respectively; p<0.05). Also renalase serum-to-urine/mg creatinine ratio was higher in CKD patients than in healthy subjects (0.863 and 0.176, respectively; p<0.05). In both groups, no correlation between renalase concentration or serum-to-urine ratio, and eGFR, was found. Conclusions Renalase is involved in chronic kidney disease pathomechanism and is highly secreted and cumulated in blood of subjects with chronic kidney disease, what is accompanied by reduction of urinary renalase excretion. This may occur due to the potential role of renalase as a cytokine, preventing further kidney, and probably heart, dysfunction or injury. Chronic kidney disease causes higher expression of renalase, but its balance between serum and urine depends on more factors and conditions, involved in CKD pathomechanism.

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P0203EARLY DETECTION OF BREAST ARTERIAL CALCIFICATION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0203 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Basma Sultan ◽

Hamdy Omar ◽

Housseini Ahmed ◽

Mahmoud Elprince ◽

Osama Anter adly ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Lipid Profile ◽

Statistical Significance ◽

University Hospital ◽

Arterial Calcification ◽

Control Group ◽

Inpatient Ward ◽

Stage 4 ◽

Ckd Stage

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.

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Investigation on Urinary and Serum Alpha Klotho in Dogs with Chronic Kidney Disease

10.21203/rs.3.rs-16759/v1 ◽

2020 ◽

Author(s):

Hong jae Yi ◽

Jong bok Lee ◽

Kyu pil Lee ◽

Kun ho Song ◽

Kyoung won Seo

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Fibroblast Growth Factor 23 ◽

Stepwise Multiple Regression ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Phosphorus Concentration ◽

Creatinine Ratio ◽

Ckd Stage ◽

Clinical Consequences

Abstract Background: As a co-receptor for fibroblast growth factor 23, klotho plays a pivotal role in phos-phate metabolism. The kidney is known to be not only the main source of soluble alpha-klotho but also functions as the principal regulator maintaining its concentration. Previous studies in human par-ticipants showed that the concentration of soluble alpha-klotho in serum and urine decreased in chronic kidney disease (CKD) patients. However, no previous study has assessed soluble alpha-klotho levels in dogs. This study aimed to measure serum and urinary alpha-klotho levels in CKD dogs and identify their associations with International Renal Interest Society (IRIS) CKD stages and other parameters known to be associated with CKD.Methods: Serum and urinary alpha klotho concentrations were measured by a commercially avail-able canine-specific sandwich enzyme-linked immunosorbent assay kit and compared between groups by a nonparametric Kruskal–Wallis test. Spearman’s correlation coefficient was used to eval-uate the relationships between variables. A stepwise multiple regression analysis was performed to estimate the effects of independent predictors on klotho concentrations.Results: The urine klotho-to-creatinine ratio (UrKl/Cr) was significantly lower in stage 3 dogs than the control group and was significantly lower in dogs with stage 3 and 4 CKD than in those with stage 1 and 2 disease. UrKl/Cr was negatively correlated with serum symmetric dimethylarginine (sSDMA), blood urea nitrogen (BUN), creatinine, and phosphorus concentration. Serum alpha-klotho concentration in dogs with stages 2 and 3 CKD were significantly lower than those in the control group. There was no significant correlation between serum alpha-klotho and BUN, creatinine, and phosphorus concentrations. No statistically significant differences were observed in UrKl/Cr and se-rum alpha-klotho concentration between groups based on sex, age, urine protein-to-creatinine ratio (UPC), or blood pressure.Conclusions: UrKl/Cr decreased in dogs with advanced CKD, and it was negatively correlated with sSDMA, BUN, creatinine, and phosphorus concentrations. Thus, klotho may play a role in the path-ogenesis of CKD and its clinical consequences, including CKD-mineral bone disorder, in dogs. Alt-hough serum klotho concentration was negatively correlated with sSDMA levels, it was not appar-ently related to IRIS CKD stage or other parameters known to be associated with CKD.

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Renalase in Haemodialysis Patients with Chronic Kidney Disease

Journal of Clinical Medicine ◽

10.3390/jcm10040680 ◽

2021 ◽

Vol 10 (4) ◽

pp. 680

Author(s):

Magda Wisniewska ◽

Natalia Serwin ◽

Violetta Dziedziejko ◽

Małgorzata Marchelek-Mysliwiec ◽

Barbara Dołegowska ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Plasma Concentrations ◽

Circulatory System ◽

Serum Levels ◽

Control Group ◽

Control Subjects ◽

Urine Concentrations ◽

Kidney Insufficiency ◽

Serum And Urine

Chronic kidney disease (CKD) is an inflammatory disease leading to kidney insufficiency and uremia. Renalase is a novel flavoprotein with enzymatic activities. Previous studies have shown that chronic kidney disease may influence renalase serum levels. Renalase metabolises catecholamines and therefore may be involved in the pathogenesis of hypertension and other diseases of the circulatory system. In this study, we examined renalase levels in serum, erythrocytes and urine from haemodialysis CKD patients. The study enrolled 77 haemodialysis CKD patients and 30 healthy subjects with normal kidney function as the control group. Renalase serum and urine concentrations in CKD patients were significantly increased when compared with control subjects (185.5 ± 64.3 vs. 19.6 ± 5.0 ng/mL; p < 0.00001 and 207.1 ± 60.5 vs. 141.6 ± 41.3 ng/mL; p = 0.00040, respectively). In contrast, renalase levels in erythrocytes were significantly lower in CKD patients when compared with control subjects (176.5 ± 60.9 vs. 233.2 ± 83.1 ng/mL; p = 0.00096). Plasma levels of dopamine, adrenaline and noradrenaline were also significantly lower in CKD patients when compared with controls. Conclusions: Increased serum and urine concentrations of renalase in haemodialysis CKD patients are likely related to compensatory production in extrarenal organs as a result of changes in the cardiovascular system and hypertension. The decreased plasma concentrations of catecholamines may be due to their increased degradation by plasma renalase. Decreased renalase levels in erythrocytes may be probably due to lower renalase synthesis by the kidneys in CKD. The results indicate the presence of renalase in erythrocytes.

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Bone Morphogenetic Proteins (BMPs), Extracellular Matrix Metalloproteinases Inducer (EMMPRIN), and Macrophage Migration Inhibitory Factor (MIF): Usefulness in the Assessment of Tubular Dysfunction Related to Chronic Kidney Disease (CKD)

Journal of Clinical Medicine ◽

10.3390/jcm10214893 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4893

Author(s):

Kinga Musiał ◽

Danuta Zwolińska

Keyword(s):

Chronic Kidney Disease ◽

Extracellular Matrix ◽

Kidney Disease ◽

Bone Morphogenetic Proteins ◽

Macrophage Migration Inhibitory Factor ◽

Fractional Excretion ◽

Tubular Dysfunction ◽

Macrophage Migration ◽

Urine Concentrations ◽

Serum And Urine

Bone morphogenetic proteins (BMP), extracellular matrix metalloproteinases inducer (EMMPRIN), and macrophage migration inhibitory factor (MIF) are known to be closely connected to renal tubule damage by experimental data; however, this has not been analyzed in children with chronic kidney disease (CKD). The aim of this study was to determine their usefulness in the assessment of CKD-related tubular dysfunction. The study group consisted of 61 children with CKD stages 1–5 and 23 controls. The serum and urine concentrations of BMP-2, BMP-6, EMMPRIN, and MIF were assessed by ELISA and their fractional excretion (FE) was calculated. The serum and urine concentrations of BMP-2, BMP-6, EMMPRIN, and MIF were significantly elevated in children with CKD vs. controls. The FE of BMP-2, FE BMP-6, and EMMPRIN increased significantly in CKD stages 1–2, but exceeded 1% in CKD stages 3–5. FE MIF became higher than in controls no sooner than in CKD 3–5, but remained below 1%. The FE values for BMP-2, BMP-6, and EMMPRIN of <1% may result from the tubular adaptive mechanisms, whereas those surpassing 1% suggest irreversible tubular damage. The analysis of serum/urinary concentrations and fractional excretion of examined parameters may allow the assessment of CKD-related tubular dysfunction.

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Iron-based phosphorus chelator: Risk of iron deposition and action on bone metabolism in uremic rats

Experimental Biology and Medicine ◽

10.1177/15353702211057280 ◽

2021 ◽

pp. 153537022110572

Author(s):

Wander Barros do Carmo ◽

Bárbara Bruna Abreu Castro ◽

Luísa Cardoso Manso ◽

Priscylla Aparecida Vieira do Carmo ◽

Clóvis Antônio Rodrigues ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Renal Function ◽

Parathyroid Hormone ◽

Calcium Carbonate ◽

Kidney Disease ◽

Therapeutic Option ◽

Fractional Excretion ◽

Control Group ◽

Clinical Settings ◽

Iron Based

Phosphate chelators are frequently used in patients with chronic kidney disease (CKD). New iron-based chelators remain understudied and offer a promising therapeutic option for the control of bone and mineral disorders of chronic kidney disease (BMD-CKD). We assessed the effect of the phosphorus chelator, chitosan-iron III (CH-FeCl), compared to calcium carbonate (CaCO3) in BMD-CKD and the potential iron overload in uremic rats. Thirty-two animals were divided into four groups, namely the control, CKD, CKD/CH-FeCl, and CKD/CaCO3 groups. CKD was induced by adding 0.75% (4 weeks) and 0.1% (3 weeks) adenine to the diet. The chelators were administered from week 3 through week 7. The renal function, BMD-CKD markers, and histomorphometry of the femur were assessed at week 7. The CKD group showed a significant increase in creatinine (83.9 ± 18.6 vs. 41.5 ± 22.1 µmol/L; P = 0.001), phosphate (3.5 ± 0.8 vs. 2.2 ± 0.2 mmol/L; P = 0.001), fractional excretion of phosphorus (FEP) (0.71 ± 0.2 vs. 0.2 ± 0.17; P = 0.0001), and FGF23 (81.36 ± 37.16 pg/mL vs. 7.42 ± 1.96; P = 0.011) compared to the control group. There was no accumulation of serum or bone iron after the use of CH-FeCl. The use of chelators reduced the FEP (control: 0.71 ± 0.20; CKD/CH-FeCl: 0.40 ± 0.16; CKD/CaCO3 0.34 ± 0.15; P = 0.001), without changes in the serum FGF23 and parathyroid hormone levels. Histomorphometry revealed the presence of bone disease with high remodeling in the uremic animals without changes with the use of chelators. The CH-FeCl chelator was efficient in reducing the FEP without iron accumulation, thereby paving the way for the use of this class of chelators in clinical settings in the future.

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P0256RESEARCH OF GUT MACROBIOTA IN PATIENTS WITH CHRONIC KIDNEY DISEASE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0256 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Kamila Olimxanova

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Intestinal Microbiota ◽

Inflammatory Markers ◽

Pathogenic Bacteria ◽

Laboratory Data ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Markers Of Inflammation ◽

The Relationship

Abstract Background and Aims Currently, it is estimated that the intestinal microbiota has hundreds of species of bacteria. It is known that intestinal dysbiosis contributes to the development of many diseases, such as obesity, diabetes mellitus, cardiovascular diseases, including CKD. The question of the relationship between bacterial contamination and the process of endogenous inflammation in patients with chronic kidney disease of the pre-dialysis stages is not completely clear. The aim of the study the composition of the intestinal microbiota in fecal samples and the level of inflammatory markers (CRP, IL-6, leukocytes) in patients with pre-dialysis stages of CKD. Method 60 patients with CKD of the pre-dialysis stages (C2-C4) were examined. The diagnosis of CKD was made on the basis of clinical, instrumental, and laboratory data. To study the relationship between the composition of the intestinal microbiota and inflammation in patients with CKD, we studied markers of inflammation such as CRP and IL-6. CRP was determined in blood serum by a highly sensitive method on a Humareader Single analyzer, IL-6 by enzyme-linked immunosorbent assay on a solid-phase analyzer. eGFR was calculated using the formula CKD-EPI-2011. The control group consisted of 30 healthy subjects. Statistical processing was carried out using methods of variation statistics. The results were processed using Microsoft Exel 2002 & Statistica 6.0. Results The average age of patients was 59 years. Of these, 25 women (40%) and 35 (60%) men. The estimated glomerular filtration rate varied from 30 to 60 ml / min / 1.73 m2, which corresponded to the indicators of the pre-dialysis stages of CKD. Analysis of intestinal microbiota showed a deficiency of Bifidobacterium bacteria (<108 CFU), and an increase in the number of Escherichia (> 108 CFU) in patients with CKD of the pre-dialysis stages. According to the results of the study, in the group of patients with CKD, the level of inflammatory markers was higher (CRP-55%, IL-6-60%, leukocytes 62%) than in the control group (CRP-45%, IL-6-40%, leukocytes 38% ) However, in men, the IL-6 index was higher than in women. In patients with CKD with obesity, the titer of pathogenic bacteria and their spectrum showed the worst results, although unreliable. Conclusion All examined patients had dysbiosis of the 2nd degree. At the same time, an imbalance of the intestinal microbiota is combined with an increased level of CRP, IL-6, and white blood cells.

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Study of Lipid Profile in Chronic Kidney Disease Patients

10.53350/pjmhs211572330 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2330-2333

Author(s):

Rashid Ahmad ◽

Khalil Ullah ◽

Ghazala Shaheen ◽

Muhammad Ikram Shah ◽

Muazzam Fuaad ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Lipid Profile ◽

Statistical Significance ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Female Ratio ◽

Low Hdl ◽

Age Range

Background and Aim: Premature atherosclerosis and increased prevalence of cardiovascular mortality are significantly associated with chronic kidney disease (CKD). The CKD risk factors contribute to cardiovascular and atherogenesis disease. Anemia, inflammation, vascular calcification, lack of physical activity, lipid disorders, endothelial dysfunction, and oxidative stress are various risk-induced factors for CKD patients. The aim of the present study was to evaluate or assess the lipid profile in chronic kidneys disease. Place and Duration of Study: Conducted at Medicine department of Lady Reading hospital, Peshawar and Pak International Medical College, Peshawar for duration of six months between November 2020 and April 2021. Materials and Methods: This cross-sectional study was carried out on 70 patients with chronic kidney disease (CKD) with an age range of 18 and 65 years. The male to female ratio was 1.3:1. A Control group of 70 patients of similar age and sex were enrolled in this study. Lipid profile and collection of blood specimen were managed from both groups were taken. Other parameters such as PPBS, creatinine, FBS, and blood urea results were compared for both groups. Results: The overall mean age of the study group patients was 42.4±11.5 years while the control group's mean age was 51.6±9.8 years. The prevalence of CKD patients was high 17 (24%) in the age range of 30-40 years. The prevalence of Dyslipidemia parameters such as High TC, High TG, High VLDL-C, HIGH LDL-C and low HDL-C was 49.8%, 66.7%, 67%, 42.5%, and 72.9% respectively. Overall dyslipidemia prevalence was 81.7%. Significant decrease in HDL-C while the increase in TG and VLDL-C was reported. On comparing hypertension comorbid conditions with triglyceride, HDL, and VLDL statistical significance was found. SPSS version 24 was used for data analysis. Conclusion: A significant amount of dyslipidemia is found in CKD patients. As a result, treating dyslipidemia will reduce mortality in CKD patients. Patients with CKD are predisposed to accelerated atherosclerosis, which increases the risk of CVD. The presence of an atherogenic lipid profile in CKD is confirmed by this study. Keywords: CKD, Lipid Profile, Hypertension, Dyslipidemia

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