Biomarkers for early detection of sickle nephropathy

Sundaram, Nambirajan; Bennett, Michael; Wilhelm, Jamie; Kim, Miok; Atweh, George F.; Devarajan, Prasad; Malik, Punam

doi:10.1002/ajh.22045

Cited by 63 publications

(75 citation statements)

References 49 publications

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“…20,[52][53][54][55][56][57] KIM-1 is a transmembrane protein whose expression and release by proximal tubular cells is increased after exposure to inflammatory stimuli. 58 Consistent with other studies, 59,60 we observed that concentrations of urine KIM-1 were increased in SCD patients with albuminuria. A unique finding of our study is that KIM-1 concentration significantly correlated with cell-free hemoglobin concentration in the urine of patients with SCD and in the supernatant of HK-2 cells exposed to cell-free hemoglobin.…”

Section: Discussionsupporting

confidence: 91%

Genetic variants and cell-free hemoglobin processing in sickle cell nephropathy

et al. 2015

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Section: Discussionsupporting

confidence: 91%

Genetic variants and cell-free hemoglobin processing in sickle cell nephropathy

et al. 2015

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“…Many studies on renal injury have shown the feasibility of this marker in predicting damage due to acute kidney injury. 30 The chronic nature of kidney damage in b-TM, likely without renal interstitial damage, may explain the normal U KIM-1 values of our patients.…”

mentioning

confidence: 61%

Urinary early kidney injury molecules in children with beta-thalassemia major

et al. 2015

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Background: The aim of this study was to investigate novel urinary biomarkers including N-acetyl-b-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and liver-type fatty acid binding protein (L-FABP) in children with b-thalassemia major (b-TM). Materials and methods: Totally, 52 patients (29 boys, 23 girls) with b-TM and 29 healthy controls (3-17 years) were included. Various demographic characteristics and blood transfusions/year, disease duration, and chelation therapy were recorded. Serum urea, creatinine, electrolytes, and ferritin and urinary creatinine, protein, calcium, phosphorus, sodium, potassium, and uric acid in first morning urine samples were measured and estimated glomerular filtration rate (eGFR) was calculated. Routine serum and urinary biochemical variables, urinary NAG to Creatinine (U NAG/Cr ), U NGAL/Cr , U KIM-1/Cr , and U L-FABP/Cr ratios were determined. Results: Patients had similar mean serum urea, creatinine and eGFR levels compared with controls (p40.05 for all). The mean urinary protein to creatinine (U Protein/Cr ) ratio was significantly higher in patients compared to the healthy subjects (0.13 ± 0.09 mg/mg and 0.07 ± 0.04 mg/mg, respectively; p50.001). Significantly increased U NAG/Cr (0.48 ± 0.58 vs. 0.23 ± 0.16, p ¼ 0.026) and U NGAL/Cr (22.1 ± 18.5 vs. 11.5 ± 6.17, p ¼ 0.01) ratios were found in b-TM patients compared with healthy controls. However, no differences were found in serum and urinary electrolytes or U KIM-1/Cr and U L-FABP/Cr ratios between patients and controls (p40.05). Significant correlations were found between urinary biomarkers and urinary electrolytes (p50.05). Conclusions: Our results suggest that urinary NAG and NGAL may be considered to be reliable markers to monitor renal injury in b-TM patients.

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“…Novel biomarkers are under investigation for use in SCD. Urinary kidney injury molecule-1 (KIM-1) and N-acetyl-b-D-glucosaminidase (NAG) presented a strong correlation with albuminuria in a recent cohort of 116 patients with SCD [25]. Urine endothelin-1 was also found to be associated with microalbuminuria in SCD patients, as well as with urinary concentration defect [26].…”

Section: Discussionmentioning

confidence: 99%

Renal Tubular Dysfunction in Sickle Cell Disease

Silva

Vieira

Couto

et al. 2013

Kidney Blood Press Res

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Background/Aims: Kidney abnormalities are one of the main chronic complications of sickle cell disease (SCD). The aim of this study is to investigate the occurrence of renal tubular abnormalities among patients with SCD. Methods: This is a prospective study with 26 SCD adult patients in Brazil. Urinary acidification and concentration tests were performed using calcium chloride (CaCl₂), after a 12h period of water and food deprivation. Fractional excretion of sodium (FE_Na), transtubular potassium gradient (TTKG) and solute free water reabsorption (TcH₂O) were calculated. The SCD group was compared to a group of 15 healthy volunteers (control group). Results: Patient`s average age and gender were similar to controls. Urinary acidification deficit was found in 10 SCD patients (38.4%), who presented urinary pH >5.3 after CaCl₂ test. Urinary osmolality was significantly lower in SCD patients (355±60 vs. 818±202mOsm/kg, p=0.0001, after 12h period water deprivation). Urinary concentration deficit was found in all SCD patients (100%). FE_Na was higher among SCD patients (0.75±0.3 vs. 0.55±0.2%, p=0.02). The TTKG was higher in SCD patients (5.5±2.5 vs. 3.0±1.5, p=0.001), and TcH₂O was lower (0.22±0.3 vs. 1.1±0.3L/day, p=0.0001). Conclusions: SCD is associated with important kidney dysfunction. The main abnormalities found were urinary concentrating and incomplete distal acidification defect. There was also an increase in the potassium transport and decrease in water reabsorption, evidencing the occurrence of distal tubular dysfunction.

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Biomarkers for early detection of sickle nephropathy

Cited by 63 publications

References 49 publications

Genetic variants and cell-free hemoglobin processing in sickle cell nephropathy

Genetic variants and cell-free hemoglobin processing in sickle cell nephropathy

Urinary early kidney injury molecules in children with beta-thalassemia major

Renal Tubular Dysfunction in Sickle Cell Disease

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