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Войти в исследования International urology and nephrology · 2025
Uncovering hidden risks: metabolic and inflammatory insights in normoalbuminuric chronic kidney disease.
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Zhang Lijuan, Bai Jiang, Di Meng, Liu Zehui, He Letian, Guo Junnan
Аннотация
OBJECTIVES: While elevated levels of albuminuria beyond 30 mg/g are linked to adverse outcomes, recent studies have revealed an increased risk of chronic kidney disease (CKD) progression and cardiovascular events within the normoalbuminuric range (urinary albumin-to-creatinine ratio, UACR < 30 mg/g). This study aims to examine metabolite levels and inflammatory markers among CKD patients in the normal albuminuria groups.
METHODS: We recruited 24 patients diagnosed with CKD exhibiting normoalbuminuria from The Kidney Precision Medicine Project (KPMP). The patients were divided into two groups based on their UACR levels: 0-15 mg/g and 15-30 mg/g. Differential metabolites were identified through Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS).
RESULTS: The results indicated that patients with CKD and a UACR of 15-30 mg/g exhibited significant pathology, including a higher percentage of tubular atrophy and elevated levels of metabolites. These metabolites were classified into Lipids (60.0%), Amino Acids and Peptides (6.6%), Cofactors and Vitamins (6.6%), and Nucleotides (3.3%), associated with porphyrin metabolism, arginine biosynthesis, lysine degradation, and fatty acid metabolism, contrasting with CKD patients having a UACR of 0-15 mg/g. Noteworthy positive correlations were observed between caprate levels and IL-12p70, gamma-glutamylleucine and IL-10, as well as taurolithocholate and IL-10.
CONCLUSION: In patients with CKD and normal albuminuria, there exist metabolic variances compared to those with high levels of albuminuria, and these metabolites are linked to inflammatory status. This offers a foundation for early detection and proactive measures before reaching the normal threshold in CKD.
METHODS: We recruited 24 patients diagnosed with CKD exhibiting normoalbuminuria from The Kidney Precision Medicine Project (KPMP). The patients were divided into two groups based on their UACR levels: 0-15 mg/g and 15-30 mg/g. Differential metabolites were identified through Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS).
RESULTS: The results indicated that patients with CKD and a UACR of 15-30 mg/g exhibited significant pathology, including a higher percentage of tubular atrophy and elevated levels of metabolites. These metabolites were classified into Lipids (60.0%), Amino Acids and Peptides (6.6%), Cofactors and Vitamins (6.6%), and Nucleotides (3.3%), associated with porphyrin metabolism, arginine biosynthesis, lysine degradation, and fatty acid metabolism, contrasting with CKD patients having a UACR of 0-15 mg/g. Noteworthy positive correlations were observed between caprate levels and IL-12p70, gamma-glutamylleucine and IL-10, as well as taurolithocholate and IL-10.
CONCLUSION: In patients with CKD and normal albuminuria, there exist metabolic variances compared to those with high levels of albuminuria, and these metabolites are linked to inflammatory status. This offers a foundation for early detection and proactive measures before reaching the normal threshold in CKD.