Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa

Background: Diabetic kidney disease is a major complication resulting from type 1 and type 2 diabetes. Currently, the microalbuminuria test is used to monitor renal function; however, it does not detect albumin until progressive loss of renal function has occurred. Objective: This study analysed th...

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Main Authors: Thapelo Mbhele, Donald M. Tanyanyiwa, Refilwe J. Moepya, Sindeep Bhana, Maya M. Makatini
Format: Article
Language:English
Published: AOSIS 2021-12-01
Series:African Journal of Laboratory Medicine
Subjects:
Online Access:https://ajlmonline.org/index.php/ajlm/article/view/1398
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author Thapelo Mbhele
Donald M. Tanyanyiwa
Refilwe J. Moepya
Sindeep Bhana
Maya M. Makatini
author_facet Thapelo Mbhele
Donald M. Tanyanyiwa
Refilwe J. Moepya
Sindeep Bhana
Maya M. Makatini
author_sort Thapelo Mbhele
collection DOAJ
description Background: Diabetic kidney disease is a major complication resulting from type 1 and type 2 diabetes. Currently, the microalbuminuria test is used to monitor renal function; however, it does not detect albumin until progressive loss of renal function has occurred. Objective: This study analysed the relationship between changes in amino acid ratios and estimated glomerular filtration rate (eGFR) decline in diabetic and non-diabetic patients. Methods: Urine samples were collected from participants between February 2019 to April 2019 and analysed from November 2020 to January 2021. Diabetic (glycated haemoglobin 6.4%) and non-diabetic patients (glycated haemoglobin ≤ 6.4%) from Chris Hani Baragwanath Hospital, South Africa, were further categorised based on the degree of renal function predicted by the eGFRs. Amino acids were quantified using tandem mass spectrometry to determine the concentrations and ratios of tyrosine/phenylalanine, ornithine/arginine, arginine/citrulline and citrulline/ornithine at different stages of the chronic kidney disease. Results: Among diabetic patients, the tyrosine/phenylalanine ratio showed a statistically significant increase (p = 0.04) as the eGFR declined from stage 1 to stage 4; the ornithine/arginine ratio showed a strong negative correlation with eGFR. The citrulline/ornithine ratio differed between the diabetic and non-diabetic patients in stage 1 of chronic kidney disease. Conclusion: Amino acid ratios (ornithine/arginine and tyrosine/phenylalanine) are affected by the progression of diabetes and can be correlated to renal function. The citrulline/ornithine ratios differ between the studied groups in stage 1 of the disease and may be utilised to predict the onset of chronic kidney disease.
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spelling doaj.art-347b4380d623459eb27a5f2f451e8ea22022-12-22T02:56:59ZengAOSISAfrican Journal of Laboratory Medicine2225-20022225-20102021-12-01101e1e710.4102/ajlm.v10i1.1398346Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South AfricaThapelo Mbhele0Donald M. Tanyanyiwa1Refilwe J. Moepya2Sindeep Bhana3Maya M. Makatini4Molecular Sciences Institute, School of Chemistry, Faculty of Science, University of the Witwatersrand, JohannesburgSchool of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Department of Chemical Pathology, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, PretoriaMolecular Sciences Institute, School of Chemistry, Faculty of Science, University of the Witwatersrand, JohannesburgSchool of Medicine, Faculty of Health Sciences, University of the Witwatersrand, JohannesburgMolecular Sciences Institute, School of Chemistry, Faculty of Science, University of the Witwatersrand, JohannesburgBackground: Diabetic kidney disease is a major complication resulting from type 1 and type 2 diabetes. Currently, the microalbuminuria test is used to monitor renal function; however, it does not detect albumin until progressive loss of renal function has occurred. Objective: This study analysed the relationship between changes in amino acid ratios and estimated glomerular filtration rate (eGFR) decline in diabetic and non-diabetic patients. Methods: Urine samples were collected from participants between February 2019 to April 2019 and analysed from November 2020 to January 2021. Diabetic (glycated haemoglobin 6.4%) and non-diabetic patients (glycated haemoglobin ≤ 6.4%) from Chris Hani Baragwanath Hospital, South Africa, were further categorised based on the degree of renal function predicted by the eGFRs. Amino acids were quantified using tandem mass spectrometry to determine the concentrations and ratios of tyrosine/phenylalanine, ornithine/arginine, arginine/citrulline and citrulline/ornithine at different stages of the chronic kidney disease. Results: Among diabetic patients, the tyrosine/phenylalanine ratio showed a statistically significant increase (p = 0.04) as the eGFR declined from stage 1 to stage 4; the ornithine/arginine ratio showed a strong negative correlation with eGFR. The citrulline/ornithine ratio differed between the diabetic and non-diabetic patients in stage 1 of chronic kidney disease. Conclusion: Amino acid ratios (ornithine/arginine and tyrosine/phenylalanine) are affected by the progression of diabetes and can be correlated to renal function. The citrulline/ornithine ratios differ between the studied groups in stage 1 of the disease and may be utilised to predict the onset of chronic kidney disease.https://ajlmonline.org/index.php/ajlm/article/view/1398diabetic nephropathyalbuminuriaamino acidslc-ms/mschronic kidney diseaseglomerular filtration rate
spellingShingle Thapelo Mbhele
Donald M. Tanyanyiwa
Refilwe J. Moepya
Sindeep Bhana
Maya M. Makatini
Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
African Journal of Laboratory Medicine
diabetic nephropathy
albuminuria
amino acids
lc-ms/ms
chronic kidney disease
glomerular filtration rate
title Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
title_full Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
title_fullStr Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
title_full_unstemmed Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
title_short Relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non-diabetic patients in South Africa
title_sort relationship between amino acid ratios and decline in estimated glomerular filtration rate in diabetic and non diabetic patients in south africa
topic diabetic nephropathy
albuminuria
amino acids
lc-ms/ms
chronic kidney disease
glomerular filtration rate
url https://ajlmonline.org/index.php/ajlm/article/view/1398
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