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Abstract: SA-PO117

Urinary DcR2/Cr Level Predicts Renal Outcome in Patients and Mouse Models with AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Yi, Xiangling, Daping Hospital, Army Medical University, Chongqing, 未选择任何内容, China
  • Chen, Jia, Daping Hospital, Army Medical University, Chongqing, 未选择任何内容, China
  • He, Yani, Daping Hospital, Army Medical University, Chongqing, 未选择任何内容, China
  • Chen, Kehong, Daping Hospital, Army Medical University, Chongqing, 未选择任何内容, China
Background

Acute kidney injury(AKI) is a well-recognized complication of critical illness with poor prognosis. Decoy receptor 2(DcR2), a senescent marker, is expressed specifically in senescent tubular epithelia. The aim of study is to investigate the association of urine DcR2 with renal outcome of AKI.

Methods

153 biopsy-proven AKI patients were included from Daping Hospital, Army Medical University from January 2018 to October 2022. A composite renal endpoint included creatinine more than 50% higher than the baseline or ESRD after 90 days. All patients were divided into positive endpoints(n=75) and negative endpoints(n=78). The clinical characteristics were collected, and the uDcR2 levels were measured and normalized to urinary cre(uDcR2/Cr). By using correlation analysis, logistic regression and Kaplan-Meier curves, we explored the relationship between uDcR2/Cr and kidney outcome. We used experimental animals to further verify,and mice were randomly divided into 3 groups as follows: control, cisplatin, and aristolochic acid.

Results

The level of uDcR2/Cr was positively correlated with cystatin C and renal pathological acute scores, and negatively correlated with eGFR. Univariate logistic regression results increase the risk factors for poor kidney prognosis are age, female, with hypertension or(and) CKD, eGFR, Cystine C and uDcR2/Cr. Multivariate logistic regression analysis showed that the effect of uDcR2/Cr on renal outcome was statistically significant. After a median follow-up of 16 months, 75 participants achieve endpoint. The ROC curve was used to analyze the value of uDcR2/Cr for predicting kidney prognosis in AKI with an area under the curve of 0.72 and the cut-off value of 365ng/g Cr. The median time from at the time of AKI to endpoint in the uDcR2/Cr≥365ng/g Cr group(7.6 months) was significantly shorter compared to the uDcR2/Cr<365ng/g Cr group(36.6 months). To explore the trend of uDcR2 levels after AKI, uDcR2/Cr levels increased at 3d in cisplain-induced and aristolochic acid-induced AKI models compared with the control group, and the levels at 7d and 21d were still higher in the two models.

Conclusion

Urinary DcR2/Cr is closely associated to kidney injury and renal prognosis of AKI, suggesting that uDcR2/Cr could sever as a novel biomarker for predicting adverse outcomes in patients and mouse models with AKI.

Funding

  • Private Foundation Support