Urinary vitamin D binding protein: a potential novel marker of renal interstitial inflammation and fibrosis.
PLoS One
; 8(2): e55887, 2013.
Article
en En
| MEDLINE
| ID: mdl-23409077
ABSTRACT
Non-invasive tubulointerstitial damage markers may allow better titration and monitoring of renoprotective therapy. We investigated the value of urinary vitamin D binding protein excretion (uVDBP) as a tubulointerstitial inflammation and fibrosis marker in adriamycin rats, and tested whether uVDBP parallels renal damage and responds to therapy intensification in humans. In adriamycin (ADR) rats, uVDBP was strongly elevated vs controls (CON) already 6 wks after nephrosis induction (ADR 727±674 [mean±SD] vs CON 9±12 µg/d, p<0.01), i.e. before onset of pre-fibrotic and inflammatory tubulointerstitial damage, and at all following 6-wk time points until end of follow up at 30 wks (ADR 1403±1026 vs CON 206±132 µg/d, p<0.01). In multivariate regression analysis, uVDBP was associated with tubulointerstitial macrophage accumulation (standardized betaâ=â0.47, pâ=â0.01) and collagen III expression (standardized betaâ=â0.44, pâ=â0.02) independently of albuminuria. In humans, uVDBP was increased in 100 microalbuminuric subjects (44±93 µg/d) and in 47 CKD patients with overt proteinuria (9.2±13.0 mg/d) compared to 100 normoalbuminuric subjects (12±12 µg/d, p<0.001). In CKD patients, uVDBP responded to intensification of renoprotective therapy (ACEi+liberal sodium 9.2±13.0 mg/d vs dual RAAS blockade+low sodium 2747±4013, p<0.001), but remained still >100-fold increased during maximal therapy vs normoalbuminurics (p<0.001), consistent with persisting tubulointerstitial damage. UVDBP was associated with tubular and inflammatory damage markers KIM-1 (standardized betaâ=â0.52, p<0.001), beta-2-microglobuline (st.betaâ=â0.45, p<0.001), cystatin C (st.betaâ=â0.40, p<0.001), MCP-1 (st.betaâ=â0.31, p<0.001) and NGAL (st.betaâ=â0.20, pâ=â0.005), independently of albuminuria. UVDBP may be a novel urinary biomarker of tubulointerstitial damage. Prospectively designed studies are required to validate our findings and confirm its relevance in the clinical setting.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Proteína de Unión a Vitamina D
/
Nefritis Intersticial
Tipo de estudio:
Prognostic_studies
Límite:
Animals
/
Humans
/
Male
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Países Bajos