학술논문
Effect of urine alkalization on urinary inflammatory markers in cystinuric patients
Document Type
Academic Journal
Author
Source
Clinical Kidney Journal. March, 2024, Vol. 17 Issue 3, p1o, 10 p.
Subject
Language
English
ISSN
2048-8505
Abstract
Background. Cystinuria is associated with a high prevalence of chronic kidney disease (CKD). We previously described a urinary inflammatory-protein signature (UIS), including 38 upregulated proteins, in cystinuric patients (Cys-patients), compared with healthy controls (HC). This UIS was higher in Cys-patients with CKD. In the present observational study, we aimed to investigate the UIS in Cys-patients without CKD and patients with calcium nephrolithiasis (Lith-patients), versus HC and the effect of urine alkalization on the UIS of Cys-patients. Methods. UIS was evaluated by nano-liquid chromatography coupled to high-resolution mass spectrometry in adult HC, Lith-patients and non-treated Cys-patients with an estimated glomerular filtration rate >60 mL/min/1.73 [m.sup.2], and after a 3-month conventional alkalizing treatment in Cys-patients. Results. Twenty-one Cys-patients [12 men, median age (interquartile range) 30.0 (25.0-44.0) years], 12 Lith-patients [8 men, 46.2 (39.5-54.2) years] and 7 HC [2 men, 43.1 (31.0-53.9) years] were included. Among the 38 proteins upregulated in our previous work, 11 proteins were also upregulated in Cys-patients compared with HC in this study (5 circulating inflammatory proteins and 6 neutrophil-derived proteins). This UIS was also found in some Lith-patients. Using this UIS, we identified two subclusters of Cys-patients (5 with a very high/high UIS and 16 with a moderate/low UIS). In the Cys-patients with very high/high UIS, urine alkalization induced a significant decrease in urinary neutrophil-derived proteins. Conclusion. A high UIS is present in some Cys-patients without CKD and decreases under alkalizing treatment. This UIS could be a prognostic marker to predict the evolution towards CKD in cystinuria. Keywords: cystinuria, inflammation, nephrolithiasis, urine proteomics
INTRODUCTION Cystinuria (OMIM 220100) is the most frequent monogenic cause of renal calculi and is responsible for 1% and 4%-8% of nephrolithiasis in adults and children, respectively [1-4]. Cystinuria affects [...]
INTRODUCTION Cystinuria (OMIM 220100) is the most frequent monogenic cause of renal calculi and is responsible for 1% and 4%-8% of nephrolithiasis in adults and children, respectively [1-4]. Cystinuria affects [...]