ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-OR038

Exosomes as Mediators of Cardiomyocyte Injury and Heart Failure in Experimental Glomerular Disease

Session Information

Category: Hypertension and CVD

  • 1601 Hypertension and CVD: Basic

Authors

  • Ray, Justina, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Raisinghani, Nikhil, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Santos-Gallego, Carlos G, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Wong, Jenny, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Li, Xisheng, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Sahoo, Susmita, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Campbell, Kirk N., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background

Cardiovascular (CV) disease is the leading cause of death in chronic kidney disease, and albuminuria is widely recognized as an independent risk factor for adverse cardiac outcomes. The molecular mechanisms linking albuminuria to CV disease, including heart failure, remain poorly understood partly due to a lack of preclinical models. The Hippo pathway- including LATS 1/2 kinases- is essential for podocyte homeostasis.

Methods

We generated a podocyte-specific LATS 1/2-knockout mouse line (PodLats-KO) using Nphs2-Cre. Kidney function and structure were assessed by BUN, serum creatinine, albuminuria, and histological analysis. Cardiac function and structure were assessed by cardiac MRI, serum biomarkers, IonOptix, histology, and bulk RNA sequencing.

Results

PodLats-KO mice developed albuminuria and focal segmental glomerulosclerosis (FSGS) by 5 weeks, with disease progression by 22 weeks. Despite preserved renal function and normal blood pressure, they died prematurely (median survival: 24.8 weeks). At 22 weeks, cardiac MRI revealed biventricular systolic dysfunction and cardiac hypertrophy. Left ventricular (LV) ejection fraction was 60.2% in WT and 43.1% in PodLats-KO (p<0.0001), and right ventricular ejection fraction was 71.6% in WT and 43.3% in PodLats-KO (p<0.0001). Telemetry monitoring demonstrated T-wave elevation preceding death, suggesting cardiac ischemia. At the cellular level, PodLats-KO cardiomyocytes showed reduced contractility, impaired calcium handling, oxidative stress, and apoptosis. RNA sequencing of LV tissue revealed broad transcriptional dysregulation, including downregulation of pathways critical to cardiac contraction.

To explore a mechanistic link, exosomes were isolated from WT and PodLats-KO kidneys. PodLats-KO kidney-derived exosomes were cardiotoxic to H9C2 cardiac myoblasts (p<0.05), caused impaired contractility in primary rat cardiomyocytes (p<0.001), and induced apoptosis following intramyocardial injection into healthy control LVs (p<0.01).

Conclusion

PodLats-KO mice develop FSGS with albuminuria, biventricular heart failure, and early cardiac death, providing an innovative model to explore molecular signaling between the kidney and heart in glomerular disease. Data suggest that kidney-derived exosomes may contribute to cardiomyocyte impairment and myocardial injury.

Funding

  • NIDDK Support

Digital Object Identifier (DOI)