期刊
NEPHRON CLINICAL PRACTICE
卷 121, 期 1-2, 页码 C42-C53出版社
KARGER
DOI: 10.1159/000342385
关键词
Acute kidney injury; IgA nephropathy; Hematuria; Macrophages; Oxidative stress
资金
- FIS [CP10/00479, PI10/00234, 10/02668, 10/02581]
- FEDER [CP04/00060, PS09/00447]
- Sociedad Espanola de Nefrologia
- ISCIII-RETIC [REDinREN/RD06/0016]
- Comunidad de Madrid [FRACM/S-BIO0283/2006]
- Programa Intensificacion Actividad Investigadora (ISCIII/)
- ISCIII-Redes RECAVA [RD06/0014/0035]
- Eurosalud [EUS2008/03565]
- cvREMOD [090010]
- ISCIII [PI10/00072]
- Fundacion Lilly
- AITER (Asociacion para el Estudio y Tratamiento de las Enfermedades Renales)
Background: Macroscopic hematuria (MH) may cause acute kidney injury (AKI) in IgA nephropathy. Up to 25% of patients with MH-associated AKI do not recover baseline renal function. Our objective was to identify subjects at high risk for an adverse renal function. Methods: We examined macrophages, oxidative stress markers (NADPH-p22 and HO-1) and the hemoglobin scavenger receptor (CD163) in renal biopsy specimens from 33 MH-AKI patients with complete recovery (CR, n = 17) or incomplete recovery (IR, n = 16) of renal function after 6.72 (range 0.5-21.5) years of follow-up. Results: CD163-expressing macrophages, HO-1 and NADPH-p22 expression were located in areas surrounding tubules with iron deposits and filled with erythrocyte casts. CD163-positive macrophages score and HO-1- and p22-positive staining correlated positively with percentage of tubules with erythrocyte casts and tubular necrosis. Macrophage infiltration, CD163-positive macrophage score, NADPH-p22- and HO-1-positive staining areas were significantly greater in IR patients when compared with CR patients. The CD163-positive macrophage score and oxidative stress markers (p22 and HO-1) were negatively correlated with renal function outcome, as determined by estimated glomerular filtration rate (eGFR) and proteinuria, at the end of the follow-up period. In multivariate analysis, the CD163-positive macrophage score remained significantly associated with final eGFR and proteinuria after adjustment by age, gender, duration of MH, initial eGFR and proteinuria. Conclusions: Increased macrophage infiltration, CD163 expression and oxidative stress are significant prognostic factors for an IR of renal function in patients with MH-associated AKI. These molecular pathways may be involved in the renal response to injury and could be useful to improve diagnosis and therapeutics. Copyright (c) 2012 S. Karger AG, Basel
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据