Alpha-1-microglobulin: Prognostic value in chronic kidney disease

Robles, Nicolás Roberto; Gómez, Juan López; Pino, G; Valladares, Julián; Gallego, Román Hernández; Cerezo, Isis

doi:10.1016/j.medcle.2020.06.062

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…We showed that this risk was particularly increased after ifosfamide exposure. Recently, increased α1MG in the urine has been reported to be a predictor of chronic kidney disease (CKD) progression and higher mortality [ 34 ], probably reflecting tubulointerstitial damage [ 35 ]. Although we could not investigate the prognostic value of α1MG because of the cross-sectional design, a strong association of α1MG with decreased GFR and albuminuria was observed.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Kooijmans

Pal

Pluijm

et al. 2022

Cancers

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The aim of this nationwide cross-sectional cohort study was to determine the prevalence of and risk factors for tubular dysfunction in childhood cancer survivors (CCS). In the DCCSS-LATER 2 Renal study, 1024 CCS (≥5 years after diagnosis), aged ≥ 18 years at study, treated between 1963 and 2001 with potentially nephrotoxic therapy (i.e., nephrectomy, abdominal radiotherapy, total body irradiation, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or hematopoietic stem cell transplantation) participated, and 500 age- and sex-matched participants from Lifelines acted as controls. Tubular electrolyte loss was defined as low serum levels (magnesium < 0.7 mmol/L, phosphate < 0.7 mmol/L and potassium < 3.6 mmol/L) with increased renal excretion or supplementation. A α1-microglobulin:creatinine ratio > 1.7 mg/mmol was considered as low-molecular weight proteinuria (LMWP). Multivariable risk analyses were performed. After median 25.5 years follow-up, overall prevalence of electrolyte losses in CCS (magnesium 5.6%, potassium 4.5%, phosphate 5.5%) was not higher compared to controls. LMWP was more prevalent (CCS 20.1% versus controls 0.4%). LMWP and magnesium loss were associated with glomerular dysfunction. Ifosfamide was associated with potassium loss, phosphate loss (with cumulative dose > 42 g/m2) and LMWP. Cisplatin was associated with magnesium loss and a cumulative dose > 500 mg/m2 with potassium and phosphate loss. Carboplatin cumulative dose > 2800 mg/m2 was associated with potassium loss. In conclusion, long-term tubular dysfunction is infrequent. Yet, ifosfamide, cisplatin and carboplatin are risk factors.

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Section: Discussionmentioning

confidence: 99%

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Kooijmans

Pal

Pluijm

et al. 2022

Cancers

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“…Its urine levels increase during renal tubules damage. Increased concentrations of beta-2 microglobulin (B2M) have been also detected when the renal tubules are damaged [ 112 ]. Hence, these molecules can function as potential markers of kidney damage, although their role must be further determined.…”

Section: Biomarkers In Cardiorenal Syndromementioning

confidence: 99%

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Gallo

Lanza

Savoia

2023

IJMS

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Cardiorenal syndrome consists in the coexistence of acute or chronic dysfunction of heart and kidneys resulting in a cascade of feedback mechanisms and causing damage to both organs associated with high morbidity and mortality. In the last few years, different biomarkers have been investigated with the aim to achieve an early and accurate diagnosis of cardiorenal syndrome, to provide a prognostic role and to guide the development of targeted pharmacological and non-pharmacological therapies. In such a context, sodium-glucose cotransporter 2 (SGLT2) inhibitors, recommended as the first-line choice in the management of heart failure, might represent a promising strategy in the management of cardiorenal syndrome due to their efficacy in reducing both cardiac and renal outcomes. In this review, we will discuss the current knowledge on the pathophysiology of cardiorenal syndrome in adults, as well as the utility of biomarkers in cardiac and kidney dysfunction and potential insights into novel therapeutics.

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“…Its urinary concentration is inversely proportional to proximal tubule resorptive capacity. 4 , 5 , 6 , 7 Further, it has been found that A1M is a potent physiological antioxidant with strong tissue-protective and cell-protective properties based on several distinct molecular mechanisms. 4 , 8 , 9 , 10 These include reductase activity, free radical scavenging, heme-binding, and mitochondrial protection.…”

mentioning

confidence: 99%