Biomarkers of renal function, which and when?

Wasung, M.; Chawla, Lakhmir S.; Madero, Magdalena

doi:10.1016/j.cca.2014.08.039

Cited by 291 publications

(269 citation statements)

References 101 publications

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“…Diabetes is the most common cause of impairment of renal function leading to end-stage renal disease and increased risk of morbidity and mortality (42)(43)(44). Deteriorated renal function in diabetes is characterised by microalbuminuria, increased plasma and reduced urine creatinine due to low creatinine clearance, reduced urea excretion, salt and water retention (45). Although we did not measure microalbuminuria, our diabetic model presented with reduced urea excretion and creatinine clearance, low urine output, Na and K retention (Figures 6-8) suggesting impairment of renal functions.…”

Section: Discussionmentioning

confidence: 99%

Metformin with insulin relieves oxidative stress and confers renoprotection in type 1 diabetes in vivo

Driver¹,

Hayangah²,

Nyane³

et al. 2017

J Nephropathol

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Background: Oxidative stress and impaired antioxidant capacity in diabetes are associated with diabetic nephropathy. Metformin, as an adjunct to insulin could decrease oxidative stress and may therefore improve renal function in type 1 diabetes (T1D). Objectives: To investigate the effects of metformin as adds-on therapy to insulin on renal dysfunction in T1D. Materials and Methods: Male Sprague-Dawley rats (230-250 g) were divided into 5 groups (n =7). Rats in groups A and B were orally treated with 3.0 mL/kg body weight (BW) of distilled water, while those in groups C and D were treated with insulin (4.0 U/kg BW bid) or oral metformin (250 mg/kg BW), respectively. Group E rats were similarly treated with both metformin and insulin. Groups B-E were rendered diabetic by intraperitoneal injections of 65 mg/kg BW of streptozotocin. Fasting blood glucose concentrations and glucose tolerance tests were done. The animals were sacrificed by halothane overdose after 56 days, blood taken by cardiac puncture and kidneys excised and stored at -80°C for further analysis. Results: Untreated diabetic rats exhibited significant weight loss, increased polydipsia and polyuria, impaired glucose tolerance, electrolyte retention, reduced creatinine clearance and urea excretion and increased oxidative stress compared to controls, respectively. However, these were reversed by treatment with metformin and insulin. Conclusions: Metformin does not improve glycemic control in TID but exerts renoprotective effects by reducing oxidative stress in the presence of insulin. Metformin should therefore be considered for adjunct therapy with insulin in TID.

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Section: Discussionmentioning

confidence: 99%

Metformin with insulin relieves oxidative stress and confers renoprotection in type 1 diabetes in vivo

Driver¹,

Hayangah²,

Nyane³

et al. 2017

J Nephropathol

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confidence: 99%

Stability of glomerular and tubular renal injury biomarkers in canine urine after 4 years of storage

et al. 2017

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The use of urine biomarkers to detect renal injury at an early stage is gaining interest in both human and veterinary medicine, 3,8,13,14,24 given that identification of early renal injury allows earlier therapeutic intervention. 17 The latter is hampered by the traditionally used diagnostic markers of decreased kidney function, serum creatinine and urea, as their concentration will only increase above the upper limit of the reference interval when >75% of nephrons are lost, making them insensitive markers for the detection of earlystage renal injury. 2,6 In contrast, urine biomarkers are generally accepted to be sensitive indicators of glomerular or tubular renal injury, and additionally have the capacity to quantify as well as localize this damage. 3,17 In research settings, enzyme-linked immunosorbent assays (ELISAs) are often used to detect and quantify biomarker proteins. Immunoassays of several glomerular and tubular biomarkers of renal injury, including immunoglobulin G (IgG) and C-reactive protein (CRP), respectively, as well as retinol-binding protein (RBP; Immunology Consultants Laboratory, Portland, OR), have been previously validated in our laboratory for use in canine urine.14 Consideration of preanalytical factors, such as sample handling and storage conditions, is important in order to perform reliable biomarker research. Because of prospective sampling, shipping, and performing analyses in batches, immediate analysis of fresh urine samples is impractical in most research settings. Therefore, storage of frozen samples for long periods (several months to years) is common. However, studies evaluating the stability of urine renal injury biomarkers during long-term storage are very scarce in veterinary medicine. Even in human medicine, relatively few studies have evaluated the impact of preanalytical factors on urine proteins. 4,7 To our knowledge, only a single urine biomarker study, investigating the stability of RBP, albumin, Abstract. Urine biomarkers are sensitive indicators of early-stage renal injury, consequently, research in this area is expanding in both human and veterinary medicine. However, studies investigating the impact of preanalytical factors, such as storage conditions, on urine biomarker concentrations are largely lacking in veterinary medicine. Therefore, we evaluated the stability of several renal injury biomarkers in canine urine after storage for 4 y at −72°C. Urine samples were collected from 26 dogs: 18 dogs with babesiosis and 8 healthy dogs. Concentrations of urine immunoglobulin G (uIgG), urine C-reactive protein (uCRP), and urine retinol-binding protein (uRBP) were measured, using validated commercial immunoassays, at the start of the study and 4 y later. To investigate the effect of long-term storage, absolute and relative differences between both measurements were compared. Additionally, dogs with babesiosis were compared with the healthy controls at both time points. Storage caused significant absolute and relative decreases in concentrations of all 3 biomarkers. Signi...

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“…21,23,24 So, in case of renal function prediction after partial nephrectomy, the feasibility of serum NGAL still seems to need more validation studies. 25,26 The known factors for affecting residual renal function after nephrectomy are preoperative renal function, age, diabetes mellitus, which is debatable.…”

Section: Area Under the Curvementioning

confidence: 99%

Clinical significance of serum neutrophil gelatinase-associated lipocalin in the early diagnosis of renal function deterioration after radical nephrectomy

Kim

Kang

et al. 2018

KMJ

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Radical nephrectomy has been treatment of choice for organ confined renal cancer with contralateral normal kidney, because radical nephrectomy can cure the renal cancer with minimal immediate problems associated with health-related quality of life due to end stage renal disease, hemodialysis, and etc. Recently, however, many small renal masses -incidentalloma -are diagnosed at health screening, and consequent nephron-sparing surgery is increasing and accepted due to benefit of residual renal function. Objectives: The standard metrics used to monitor the progression of acute kidney injury (AKI) include markers such as serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate (eGFR). Moreover, neutrophil gelatinase-associated lipocalin (NGAL) expression has been reported to modulate oxidative stress. Methods: We aimed to evaluate the usefulness of serum NGAL levels for monitoring renal function after radical nephrectomy (RN). We prospectively collected data from 30 patients who underwent RN. We analyzed serum NGAL and creatinine at 6 time points: preoperative day 1, right after surgery, 6 hours after surgery, postoperative day (POD) 1, POD 3, and POD 5. We compared these measurements according to the eGFR values (classified as chronic kidney disease stage III; CKD III or not) using data obtained 3 months after surgery. Results: The mean age was 65.5 years (range, 45-77 years), and the male-to-female ratio was 2:1. At the last follow-up examination, there were 12 patients (40%) with CKD III. Using receiver operating characteristic analysis, we found that serum creatinine on POD 5 (area under the curve [AUC], 0.887; P = 0.000) and NGAL at 6 hours after LRN (AUC, 0.743, P = 0.026) were significant predictors of CKD III. The development of CKD III after LRN was associated with the serum creatinine level on POD 5 and the NGAL at 6 hours after surgery. Conclusions: Compared to serum creatinine, serum NGAL enabled earlier prediction of postoperative CKD III. Therefore, serum NGAL measured 6 hours after surgery could be a useful marker for managing patients after RN.

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Biomarkers of renal function, which and when?

Cited by 291 publications

References 101 publications

Metformin with insulin relieves oxidative stress and confers renoprotection in type 1 diabetes in vivo

Metformin with insulin relieves oxidative stress and confers renoprotection in type 1 diabetes in vivo

Stability of glomerular and tubular renal injury biomarkers in canine urine after 4 years of storage

Clinical significance of serum neutrophil gelatinase-associated lipocalin in the early diagnosis of renal function deterioration after radical nephrectomy

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