Kidney Week

Abstract: TH-PO110

Urinary Exosomal MicroRNA-21 as a Marker of Scrub Typhus-Associated AKI

Session Information

• AKI: Biomarkers, Drugs, Onco-Nephrology
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Sun, In O, Presbyterian Medical Center, Jeonju, Korea, Jeonju, Korea (the Republic of)

In O Sun,

• Oh, Ju hwan, Presbyterian Medical Center, Jeonju, Korea, Jeonju, Korea (the Republic of)

Ju hwan Oh,

Background

Extracellular vesicles contain various molecules including DNA, mRNA, and microRNA (miRNA), and are involved in cell-to-cell communication. MiRNA-21 is reported to be a biomarker for detection of acute kidney injury (AKI). The aim of this study is to investigate the clinical significance of urinary exosomal miRNA-21 for AKI in patients with scrub typhus.

Methods

In a cross-sectional study, we collected 138 urine samples at the time of admission from 145 patients with scrub typhus. For 25 patients with scrub typhus-associated AKI and 25 age, sex-matched patient without AKI, we measured miRNA-21 in urinary exosomal fraction. Then, we investigated correlation between urinary exosomal miRNA-21 and clinical parameters.

Results

Compared with patients in the non-AKI group, patients in the AKI group had worse renal function (30 ± 13 vs. 56 ± 20 mL/min/1.73m², P<0.01) at admission and higher total leukocyte counts(10.4 × 10³/ mL vs. 5.2× 10³/mL, P<0.01). Serum NGAL (404 ± 269 vs. 104± 51 ng/mL, P<0.01) and urine NGAL/creatinine values (371± 672 vs. 37± 57 ng/mg, P<0.01) were higher in the AKI group than in the non-AKI group. The levels of urinary exosomal miRNA-21 (17.8 ± 1.8vs. 20.1± 1.2 △Ct value of miRNA-21, P<0.01) were higher in the AKI group than in the non-AKI group, while those levels in urinary supernatant were not different between two groups. Urinary exosomal miRNA-21 levels correlated directly with total leukocyte counts and serum NGAL values and inversely with estimated glomerular filtration rate. The reciver operator characteristics curve analysis for urinary exosomal miRNA-21 showed good discriminative power for detectng scrub typhus-associated AKI, with area under the curved value of 0.887.

Conclusion

Urinary exosomal miRNA-21 could be a surrogate markers for the diagnosis of scrub typhus–associated AKI.