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Tytuł pozycji:

Differences in proximal tubular solute clearance across common etiologies of chronic kidney disease.

Tytuł:
Differences in proximal tubular solute clearance across common etiologies of chronic kidney disease.
Autorzy:
Wang K; Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA.; Kidney Research Institute, Seattle, WA, USA.
Zelnick LR; Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA.; Kidney Research Institute, Seattle, WA, USA.
Hoofnagle AN; Kidney Research Institute, Seattle, WA, USA.; Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
Chen Y; Kidney Research Institute, Seattle, WA, USA.; Department of Epidemiology, University of Washington, Seattle, WA, USA.
de Boer IH; Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA.; Kidney Research Institute, Seattle, WA, USA.
Himmelfarb J; Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA.; Kidney Research Institute, Seattle, WA, USA.
Kestenbaum B; Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA.; Kidney Research Institute, Seattle, WA, USA.
Źródło:
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2020 Nov 01; Vol. 35 (11), pp. 1916-1923.
Typ publikacji:
Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:
English
Imprint Name(s):
Publication: Oxford : Oxford University Press
Original Publication: [Berlin ; New York, NY] : Springer International, [c1986-
MeSH Terms:
Glomerular Filtration Rate*
Diabetic Nephropathies/*pathology
Kidney Tubules, Proximal/*pathology
Renal Insufficiency, Chronic/*complications
Cohort Studies ; Diabetic Nephropathies/etiology ; Diabetic Nephropathies/metabolism ; Female ; Humans ; Kidney Tubules, Proximal/metabolism ; Male ; Middle Aged
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Grant Information:
K24 DK103986 United States DK NIDDK NIH HHS; R01 DK107931 United States DK NIDDK NIH HHS; T32 DK007467 United States DK NIDDK NIH HHS
Contributed Indexing:
Keywords: chronic kidney disease; tubular secretion; tubular secretory solute clearance
Entry Date(s):
Date Created: 20190727 Date Completed: 20210308 Latest Revision: 20220401
Update Code:
20240105
PubMed Central ID:
PMC7643672
DOI:
10.1093/ndt/gfz144
PMID:
31347660
Czasopismo naukowe
Background: Laboratory measures of glomerular function such as the glomerular filtration rate (GFR) contribute toward clinical evaluation of chronic kidney disease (CKD). However, diverse CKD etiologies have distinct pathological mechanisms that may differentially impact the kidney tubules. Little is known regarding how tubular function changes with varying kidney disease types.
Methods: We used targeted mass spectrometry to quantify paired serum and urine concentration of 11 solutes of proximal tubular secretion in 223 patients from an outpatient CKD cohort. We reviewed clinic notes to ascertain the primary CKD diagnosis and categorized these as vascular, diabetic, glomerular or tubulointerstitial. We used one-way analysis of variance to compare secretory solute clearance across diagnoses setting a false discovery threshold of ≤5% and used linear regression to compare differences after adjustments for estimated GFR, age, race, sex, body mass index and urine albumin excretion.
Results: After full adjustment, glomerular disease was associated with higher clearances of three tubular secretory solutes compared with vascular disease: 48% higher isovalerylglycine clearance [95% confidence interval (CI) 18-87%], 28% higher kynurenic acid clearance (95% CI 3-59%) and 33% higher tiglylglycine clearance (95% CI 7-67%). Diabetic kidney disease (DKD) was associated with 39% higher isovalerylglycine clearance compared with vascular disease (95% CI 13-72%).
Conclusion: Glomerular disorders and DKD are associated with higher net clearances of several secretory solutes compared with vascular causes of kidney disease. These findings suggest that different underlying etiologies of CKD may differentially impact proximal tubular secretory pathways.
(© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

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