Urinary A- and C-megalin predict progression of diabetic kidney disease: an exploratory retrospective cohort study

被引：6

作者：

Iida, Tomomichi ^{[1
,2
]}

Hosojima, Michihiro ^{[3
]}

Kabasawa, Hideyuki ^{[3
]}

Yamamoto-Kabasawa, Keiko ^{[4
]}

Goto, Sawako ^{[1
]}

Tanaka, Takahiro ^{[5
]}

Kitamura, Nobutaka ^{[5
]}

Nakada, Mitsutaka ^{[6
]}

Itoh, Shino ^{[6
]}

Ogasawara, Shinya ^{[6
]}

Kaseda, Ryohei ^{[2
]}

Suzuki, Yoshiki ^{[2
]}

Narita, Ichiei ^{[2
]}

Saito, Akihiko ^{[1
]}

机构：

[1] Niigata Univ, Kidney Res Ctr, Grad Sch Med & Dent Sci, Dept Appl Mol Med, 1-757 Asahimachi Dori,Chuo ku, Niigata, Niigata 9518510, Japan

[2] Niigata Univ, Kidney Res Ctr, Grad Sch Med & Dent Sci, Div Clin Nephrol & Rheumatol, 1-757 Asahimachi Dori,Chuo ku, Niigata, Niigata 9518510, Japan

[3] Niigata Univ, Kidney Res Ctr, Grad Sch Med & Dent Sci, Dept Clin Nutr Sci, 1-757 Asahimachi Dori,Chuo ku, Niigata, Niigata 9518510, Japan

[4] Niigata Univ, Grad Sch Med & Dent Sci, Dept Hlth Promot Med, 1-757 Asahimachi Dori,Chuo ku, Niigata, Niigata 9518510, Japan

[5] Niigata Univ, Med & Dent Hosp, Clin & Translat Res Ctr, 1-754 Asahimachi Dori,Chuo ku, Niigata, Niigata 9518520, Japan

[6] Denka Co Ltd, DENKA Innovat Ctr, Diagnost Res Dept, Life Innovat Res Inst, 3-5-1 Asahimachi, Machida, Tokyo 1948560, Japan

来源：

JOURNAL OF DIABETES AND ITS COMPLICATIONS | 2022年 / 36卷 / 11期

基金：

日本学术振兴会;

关键词：

Diabetic kidney disease; Estimated glomerular filtration rate; Megalin; PROXIMAL TUBULE; FULL-LENGTH; RECEPTOR; NEPHROPATHY; INHIBITOR; EXCRETION; CHILDREN;

D O I：

10.1016/j.jdiacomp.2022.108312

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims: Megalin, a proximal tubular endocytosis receptor, is excreted in urine in two forms: ectodomain (Amegalin) and full-length (C-megalin). We explored whether urinary megalin levels can be used as independent prognostic biomarkers in the progression of diabetic kidney disease (DKD).Methods: The associations between baseline urinary A-megalin/creatinine (Cr) and/or C-megalin/Cr levels and the subsequent estimated glomerular filtration rate (eGFR) slope were analyzed using a generalized estimating equation. Patients were categorized into higher or lower groups based on the optimal cutoff values, obtained from a receiver operating characteristic curve, of the two forms of urinary megalin.Results: We retrospectively analyzed 188 patients with type 2 diabetes. The eGFR slopes of the higher A-megalin/ Cr and higher C-megalin/Cr groups were - 0.904 and -0.749 ml/min/1.73 m2/year steeper than those of the lower groups, respectively. Moreover, the eGFR slope was -1.888 ml/min/1.73 m2/year steeper in the group with both higher A- and higher C-megalin/Cr than in the other group. These results remained significant when adjusted for known urinary biomarkers (albumin, alpha 1-microglobulin, beta 2-microglobulin, and N-acetyl-beta-Dglucosaminidase).Conclusions: Urinary A- and C-megalin/Cr levels are likely to be prognostic biomarkers in the progression of DKD independent of other urinary biomarkers.

引用

页数：8

共 45 条

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