Kidney Injury Marker 1 and Neutrophil Gelatinase-Associated Lipocalin in Chronic Kidney Disease

Abstract

The current categorization of chronic kidney disease (CKD) is based on biomarkers of the glomerular function (estimated glomerular filtration rate, eGFR) and injury (urinary albumin creatinine ratio, UACR) and provides information on the risk of death and of progression of kidney disease. However, there are gaps in knowledge regarding the risk stratification of elderly patients with eGFR 45-60 ml/min/1.73 m² and of younger patients with higher eGFR but physiological albuminuria. In this regard, most of the kidney cell mass is composed of tubules. Recent studies have explored whether biomarkers derived from the acute kidney injury literature, which are mainly tubular injury markers, may improve the information provided by eGFR and UACR. We now review the potential role of kidney injury molecule 1 (KIM-1), hepatitis A virus cellular receptor 1, T-cell immunoglobulin and mucin domain-1 and neutrophil gelatinase-associated lipocalin (NGAL)/lipocalin 2 as biomarkers for kidney or cardiovascular outcomes in CKD patients. In general, neither urinary KIM-1 nor urinary NGAL (uNGAL) outperform or add relevant information to eGFR or UACR. However, promising results were obtained for circulating KIM-1 prediction of renal outcomes in type 1 diabetes. Additionally, uNGAL may have some value in non-proteinuric patients and increased values have been observed in persons at risk for Mesoamerican nephropathy. Further studies are warranted in these niche populations.

Podwyższone stężenia lipokaliny-2 w surowicy krwi są związane ze wskaźnikami metabolizmu glukozy i metabolizmu kostnego w przebiegu cukrzycy typu 2

“…Since BMI and sex have been shown to be related to serum LCN2 levels in human, the subjects in the NGT group who had no statistical differences in those parameters compared to T2DM group were chosen as controls in this study [14,20]. A number of factors correlating to serum LCN2 levels have been identified in the past decade, including lung injury, kidney injury, pancreatic injury, and cardiovascular disease [3,5,21,22]. Moreover, diabetic complications such as diabetic retinopathy and diabetic kidney disease have been demonstrated to be positively correlated to serum or urinary LCN2 levels [23,24].…”

“…LCN2 is abundantly expressed in various tissues such as immune cells, adipose tissue, lung, liver, kidney, and uterus, and is implicated in diseases associated with inflammation and obesity including inflammatory bowel disease, cardiovascular disease, acute kidney injury, acute pancreatitis, cancer, multiple sclerosis, and type 2 diabetes mellitus (T2DM) [2][3][4][5][6][7].…”

Chronic kidney disease and coenzyme Q10 supplementation

“…Oxidative stress can also result in inflammation which can mediate a host of chronic diseases (Stepien et al, 2017;refs: DelaCruz & Kang, 2018;Grazioli & Pugia, 2018;Meyer et al, 2018). In addition, the levels of a number of pro-inflammatory cytokines considered to be uremic toxins increase in CKD, contributing to the pathophysiology of this condition ( Castillo-Rodriguez et al, 2017).The release of mitochondria-derived damageassociated molecular patterns (DAMPs) as the result of mitochondrial dysfunction. may also contribute to the inflammatory response by interacting with receptors similar to those involved in the pathogen-associated immune response (Picca et al, 2017).…”

Downregulation of kidney protective factors by inflammation: role of transcription factors and epigenetic mechanisms

“…Clinical trials aimed at boosting HO-1 expression by administering hemin are underway in the context of improving nephroprotection (114). Injured tubular cells also markedly increase the expression of molecules such as kidney injury molecule 1 (KIM1) and neutrophil-gelatinase associated lipocalin (NGAL), which in the acute setting may also prevent amplification of kidney injury (14). KIM1 is a scavenger membrane receptor for phosphatidylserine and allows phagocytosis of apoptotic cells.…”