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Kidney Week

Abstract: FR-PO076

A Novel Biomarker for Detecting Both AKI and CKD

Session Information

  • AKI Clinical: Predictors
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Sanchez-Navarro, Andrea, Molecular Physology Unit, MEXICO, DF, Mexico
  • Pérez-villalva, Rosalba, Molecular Physiology Unit, México, Mexico
  • Mejia-Vilet, Juan M., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico
  • Linares, Nadyeli, Molecular Physiology Unit, México, Mexico
  • Bobadilla, Norma, Molecular Physology Unit, MEXICO, DF, Mexico
Background

The early diagnosis of AKI and CKD undoubtedly will have a potential impact on the treatment of these pathologies and on the kidney health. This study was designed to provide a suitable method for overcoming the limitations of the procedures or methods previously used for the AKI and CKD diagnosis.

Methods

Abnormal presence of serpinA3K in urine samples from animals with CKD was identified by mass spectrometry. We evaluated the urinary serpinA3K in rats and in patients with AKI, as well as, the temporal course of serpinA3K presence during the AKI to CKD transition and in urines from patients previously diagnosed with CKD by renal biopsy and without renal dysfunction. For AKI model, 44 Wistar rats were divided in different periods of reperfusion: 3, 6, 9, 12, 18, 24, 48, 72, 96, or 120 h after renal bilateral ischemia (45 min) and compared to sham-operated rats; in addition, 20 rats were studied to evaluate different renal injury severity induced by 15, 30, 45 or 60 min of ischemia. For CKD model, 36 rats were divided in: sham operated (S) or nephrectomy plus left renal ischemia of 45 min (UNx+IR) groups; these rats were studied 1, 2, 3, or 4 months. Mean arterial pressure, creatinine clearance, and renal blood flow were determined. Urinary serpinA3K was evaluated in all these rats and in the urines from patients diagnosed with AKI or CKD.

Results

SerpinA3K was not detected in the urines from sham rats or healthy volunteers. In contrast, serpinA3K appeared in the rat urines and it increased proportionally to the AKI severity. This protein was detected since 3 h post-ischemia. Accordingly, abnormal urinary serpinA3K was found in patients with AKI. After 4 months, the UNx+IR rats developed CKD characterized by a progressive proteinuria, renal dysfunction and tubulointerstitial fibrosis. Interestingly, urinary serpinA3K, was detected since the 1st-month and progressively increased in the follow-up and correlated with the tubulointerstitial fibrosis. In CKD patients, urinary serpinA3K was significantly elevated without changes in serum creatinine.

Conclusion

We demonstrated that urinary serpinA3K is a promising and early biomarker to detect AKI, AKI to CKD transition and CKD from different etiologies. In addition, this biomarker could detect renal injury before renal dysfunction.

Funding

  • Government Support - Non-U.S.