Abstract: TH-PO435
Utility of D-Serine in the Estimation of GFR and the Diagnosis of Kidney Diseases
Session Information
- CKD: Clinical, Outcomes, Trials - I
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Hesaka, Atsushi, National Institute of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Japan
- Sakai, Shinsuke, Osaka University, Suita, OSAKA-FU, Japan
- Horio, Masaru, Osaka University Graduate School of Medicine, Ashiya, Japan
- Isaka, Yoshitaka, Osaka University Graduate School of Medicine, Ashiya, Japan
- Kimura, Tomonori, National Institute of Biomedical Innovation, Health and Nutrition (NIBIOHN), Ibaraki, Osaka, Japan
Background
Glomerular filtration ratio (GFR), measured by inulin clearance, is rarely used in clinics due to its methodological complexity. As a replacement, estimated GFR (eGFR), calculated from either serum creatinine or serum cystatin C, is widely used currently, but it has some limitations such as the accuracy. D-Amino acids, long-term undetected enantiomers of L-amino acids, is now emerging as a potential biomarker especially in kidney diseases. Here we investigated the potential of D-serine as a biomarker for kidney function and diseases.
Methods
Inulin clearance and chiral amino metabolomics were simultaneously performed in 11 CKD patients and 15 non-CKD participants. The association between chiral amino acids and clinical parameters was analyzed using either unsupervised principal component analysis (PCA) or supervised orthogonal partial least squares (OPLS) analysis. Additionally, D-serine was monitored in one patient with systemic erythematous lupus nephritis during its recovery phase.
Results
The plasma level of D-serine correlated well with the actual GFR, and this correlation was compatible with those of serum creatinine and cystatin C. Fractional excretion (Fe) of D-serine in non-CKD was much higher than those of L-serine, but its variance was maintained within a certain limited range. Although Fe of D-serine was uncorrelated with GFR, it reflected the presence of CKD. The combination of plasma and Fe of D-serine effectively separated the CKD from non-CKD participants. This concept was exemplified in a patient with SLE, in which the combination of plasma and Fe of D-serine well-reflected its recovery phase.
Conclusion
D-serine would benefit patients with kidney diseases via accurate estimation of GFR and estimation of disease activities.