Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease
Abstract Background Diabetic kidney diseases (DKD) is a the most common cause of end-stage kidney disease (ESKD) around the world. Previous studies suggest that urinary podocyte stress biomarker, e.g. podocin:nephrin mRNA ratio, is a surrogate marker of podocyte injury in non-diabetic kidney disease...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-024-03471-8 |
| _version_ | 1797276667826143232 |
|---|---|
| author | Lingfeng Zeng Jack Kit-Chung Ng Winston Wing-Shing Fung Gordon Chun-Kau Chan Kai-Ming Chow Cheuk-Chun Szeto |
| author_facet | Lingfeng Zeng Jack Kit-Chung Ng Winston Wing-Shing Fung Gordon Chun-Kau Chan Kai-Ming Chow Cheuk-Chun Szeto |
| author_sort | Lingfeng Zeng |
| collection | DOAJ |
| description | Abstract Background Diabetic kidney diseases (DKD) is a the most common cause of end-stage kidney disease (ESKD) around the world. Previous studies suggest that urinary podocyte stress biomarker, e.g. podocin:nephrin mRNA ratio, is a surrogate marker of podocyte injury in non-diabetic kidney diseases. Method We studied 118 patients with biopsy-proved DKD and 13 non-diabetic controls. Their urinary mRNA levels of nephrin, podocin, and aquaporin-2 (AQP2) were quantified. Renal events, defined as death, dialysis, or 40% reduction in glomerular filtration rate, were determined at 12 months. Results Urinary podocin:nephrin mRNA ratio of DKD was significantly higher than the control group (p = 0.0019), while urinary nephrin:AQP2 or podocin:AQP2 ratios were not different between groups. In DKD, urinary podocin:nephrin mRNA ratio correlated with the severity of tubulointerstitial fibrosis (r = 0.254, p = 0.006). and was associated with the renal event-free survival in 12 months (unadjusted hazard ratio [HR], 1.523; 95% confidence interval [CI] 1.157–2.006; p = 0.003). After adjusting for clinical and pathological factors, urinary podocin:nephrin mRNA ratio have a trend to predict renal event-free survival (adjusted HR, 1.327; 95%CI 0.980–1.797; p = 0.067), but the result did not reach statistical significance. Conclusion Urinary podocin:nephrin mRNA ratio has a marginal prognostic value in biopsy-proven DKD. Further validation is required for DKD patients without kidney biopsy. |
| first_indexed | 2024-03-07T15:31:32Z |
| format | Article |
| id | doaj.art-3ae9e03ea2a94f6d889ea521095f27a7 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-07T15:31:32Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-3ae9e03ea2a94f6d889ea521095f27a72024-03-05T16:22:36ZengBMCBMC Nephrology1471-23692024-01-012511710.1186/s12882-024-03471-8Urinary podocyte stress marker as a prognostic indicator for diabetic kidney diseaseLingfeng Zeng0Jack Kit-Chung Ng1Winston Wing-Shing Fung2Gordon Chun-Kau Chan3Kai-Ming Chow4Cheuk-Chun Szeto5Department of General Medicine, The Xiangya Second Hospital of Central South UniversityCarol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales HospitalCarol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales HospitalCarol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales HospitalCarol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales HospitalCarol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales HospitalAbstract Background Diabetic kidney diseases (DKD) is a the most common cause of end-stage kidney disease (ESKD) around the world. Previous studies suggest that urinary podocyte stress biomarker, e.g. podocin:nephrin mRNA ratio, is a surrogate marker of podocyte injury in non-diabetic kidney diseases. Method We studied 118 patients with biopsy-proved DKD and 13 non-diabetic controls. Their urinary mRNA levels of nephrin, podocin, and aquaporin-2 (AQP2) were quantified. Renal events, defined as death, dialysis, or 40% reduction in glomerular filtration rate, were determined at 12 months. Results Urinary podocin:nephrin mRNA ratio of DKD was significantly higher than the control group (p = 0.0019), while urinary nephrin:AQP2 or podocin:AQP2 ratios were not different between groups. In DKD, urinary podocin:nephrin mRNA ratio correlated with the severity of tubulointerstitial fibrosis (r = 0.254, p = 0.006). and was associated with the renal event-free survival in 12 months (unadjusted hazard ratio [HR], 1.523; 95% confidence interval [CI] 1.157–2.006; p = 0.003). After adjusting for clinical and pathological factors, urinary podocin:nephrin mRNA ratio have a trend to predict renal event-free survival (adjusted HR, 1.327; 95%CI 0.980–1.797; p = 0.067), but the result did not reach statistical significance. Conclusion Urinary podocin:nephrin mRNA ratio has a marginal prognostic value in biopsy-proven DKD. Further validation is required for DKD patients without kidney biopsy.https://doi.org/10.1186/s12882-024-03471-8PodocyteProteinuriaChronic kidney diseaseanemia |
| spellingShingle | Lingfeng Zeng Jack Kit-Chung Ng Winston Wing-Shing Fung Gordon Chun-Kau Chan Kai-Ming Chow Cheuk-Chun Szeto Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease BMC Nephrology Podocyte Proteinuria Chronic kidney disease anemia |
| title | Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| title_full | Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| title_fullStr | Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| title_full_unstemmed | Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| title_short | Urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| title_sort | urinary podocyte stress marker as a prognostic indicator for diabetic kidney disease |
| topic | Podocyte Proteinuria Chronic kidney disease anemia |
| url | https://doi.org/10.1186/s12882-024-03471-8 |
| work_keys_str_mv | AT lingfengzeng urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease AT jackkitchungng urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease AT winstonwingshingfung urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease AT gordonchunkauchan urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease AT kaimingchow urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease AT cheukchunszeto urinarypodocytestressmarkerasaprognosticindicatorfordiabetickidneydisease |