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Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease

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A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 28669

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Dr. Cristina Capusa

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Nephrology Dept. at the “Dr. Carol Davila” Teaching Hospital of Nephrology, “Carol Davila” University of Medicine and Pharmacy, 010731 București, Romania
Interests: chronic kidney disease; oxidative stress; renal anemia; intravenous iron; CKD-related mineral and bone disorders; kidney biopsy in glomerular diseases
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Dear Colleagues,

Chronic kidney disease is a public health issue of growing importance worldwide because of its impact on both individual morbidity and mortality and its economic burden for healthcare systems. In recent years, our understanding of its pathogenesis has developed, in terms of deciphering its molecular and cellular pathways of progression. The roles of podocyte lesions, interstitial fibrosis, tubular atrophy, oxidative stress and inflammation were postulated and extensively studied, sometimes yielding conflicting results.

Consequently, breakthrough research on new diagnosis biomarkers means that the early recognition of this condition is being promoted. From the "omics" approach which have shed insights into some of these aspects to biomarkers which are readily available in the daily medical practice and the contribution of artificial intelligence, the field is almost endless.

Additionally, novel therapeutical interventions to halt or delay the progression of kidney function decline might be designed, some with already proven efficacy and some currently in the laboratory pipeline and awaiting clinical validation.

In this Special Issue, we will collate the most essential knowledge from various research centers, focused on the theoretical background or experimental and clinical studies of the pathogenesis, diagnosis and treatment of chronic kidney disease. This can provide a useful tool for medical practitioners, medical students and future researchers in this scientific field.

Dr. Cristina Capusa
Guest Editor

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Keywords

chronic kidney disease progression
kidney interstitial fibrosis
oxidative stress
inflammation
genomics
transcriptomics
biomarkers
machine learning
novel therapies

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Published Papers (11 papers)

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Research

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17 pages, 4207 KiB

Open AccessArticle

Untargeted Metabolomics by Ultra-High-Performance Liquid Chromatography Coupled with Electrospray Ionization-Quadrupole-Time of Flight-Mass Spectrometry Analysis Identifies a Specific Metabolomic Profile in Patients with Early Chronic Kidney Disease

by Mihaela-Roxana Glavan, Carmen Socaciu, Andreea Iulia Socaciu, Florica Gadalean, Octavian M. Cretu, Adrian Vlad, Danina M. Muntean, Flaviu Bob, Oana Milas, Anca Suteanu, Dragos Catalin Jianu, Maria Stefan, Lavinia Balint, Silvia Ienciu and Ligia Petrica

Biomedicines 2023, 11(4), 1057; https://doi.org/10.3390/biomedicines11041057 - 30 Mar 2023

Cited by 5 | Viewed by 2373

Abstract

Chronic kidney disease (CKD) has emerged as one of the most progressive diseases with increased mortality and morbidity. Metabolomics offers new insights into CKD pathogenesis and the discovery of new biomarkers for the early diagnosis of CKD. The aim of this cross-sectional study was to assess metabolomic profiling of serum and urine samples obtained from CKD patients. Untargeted metabolomics followed by multivariate and univariate analysis of blood and urine samples from 88 patients with CKD, staged by estimated glomerular filtration rate (eGFR), and 20 healthy control subjects was performed using ultra-high-performance liquid chromatography coupled with electrospray ionization-quadrupole-time of flight-mass spectrometry. Serum levels of Oleoyl glycine, alpha-lipoic acid, Propylthiouracil, and L-cysteine correlated directly with eGFR. Negative correlations were observed between serum 5-Hydroxyindoleacetic acid, Phenylalanine, Pyridoxamine, Cysteinyl glycine, Propenoylcarnitine, Uridine, and All-trans retinoic acid levels and eGFR. In urine samples, the majority of molecules were increased in patients with advanced CKD as compared with early CKD patients and controls. Amino acids, antioxidants, uremic toxins, acylcarnitines, and tryptophane metabolites were found in all CKD stages. Their dual variations in serum and urine may explain their impact on both glomerular and tubular structures, even in the early stages of CKD. Patients with CKD display a specific metabolomic profile. Since this paper represents a pilot study, future research is needed to confirm our findings that metabolites can serve as indicators of early CKD. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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13 pages, 1501 KiB

Open AccessArticle

Screening Cases of Suspected Early Stage Chronic Kidney Disease from Clinical Laboratory Data: The Comparison between Urine Conductivity and Urine Protein

by Ming-Feng Wu, Ching-Hsiao Lee, Po-Hsin Pai and Jiunn-Min Wang

Biomedicines 2023, 11(2), 379; https://doi.org/10.3390/biomedicines11020379 - 27 Jan 2023

Cited by 2 | Viewed by 2092

Abstract

(1) Background: Chronic kidney disease (CKD) affects more than 800 million global population. Early detection followed by clinical management is among the best approaches for the affected individuals. However, a sensitive screening tool is not yet available. (2) Methods: We retrospectively reviewed 600 patients aged >20 years with a full range of estimated glomerular filtration rate (eGFR) for clinical assessment of kidney function between 1 January 2020, to 30 April 2021, at the Taichung Veterans General Hospital, Taichung, Taiwan. With stratified sampling based on the level of eGFR, participants were evenly grouped into training and validation sets for predictive modeling. Concurrent records of laboratory data from urine samples were used as inputs to the model. (3) Results: The predictive model proposed two formulae based on urine conductivity for detecting suspected early-stage CKD. One formula, P_male45, was for used male subjects aged ≥45 years, and it had a prediction accuracy of 76.3% and a sensitivity of 97.3%. The other formula, P_female55, was used for female subjects aged ≥55 years. It had a prediction accuracy of 81.9% and a sensitivity of 98.4%. Urine conductivity, however, had low associations with urine glucose and urine protein levels. (4) Conclusion: The two predictive models were low-cost and provided rapid detection. Compared to urine protein, these models had a better screening performance for suspected early-stage CKD. It may also be applied for monitoring CKD in patients with progressing diabetes mellitus. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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14 pages, 3233 KiB

Open AccessArticle

Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis

by Felix-Mihai Maralescu, Adrian Vaduva, Adalbert Schiller, Ligia Petrica, Ioan Sporea, Alina Popescu, Roxana Sirli, Alis Dema, Madalina Bodea, Iulia Grosu and Flaviu Bob

Biomedicines 2023, 11(2), 365; https://doi.org/10.3390/biomedicines11020365 - 26 Jan 2023

Cited by 7 | Viewed by 1784

Abstract

Introduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue’s stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Materials and methods: Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. Results: In total, 26 men and 14 women with a mean age of 52.35 ± 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 ± 35.49 mL/min/1.73m², and a mean proteinuria of 6.39 ± 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of <20.77 kPa with the area under the curve (AUC) of 0.860, a p < 0.001 with 88.89% sensitivity, and a 75% specificity for the 2D SWE PLUS measures and a cut-off value of <2.8 Pa.s with an AUC of 0.792, a p < 0.001 with 94% sensitivity, and a 60% specificity for the Vi PLUS measures. We also found a cut-off value of <19.75 kPa for the 2D SWE PLUS measures (with an AUC of 0.789, p = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of <1.28 Pa.s for the Vi PLUS measures (with an AUC 0.829, p = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (r = 0.7065, p < 0.0001) and Vi PLUS values (r = 0.3637, p < 0.0211). C reactive protein (CRP) correlates with the Vi PLUS measures (r = −0.3695, p = 0.0189) but not with the 2D SWE PLUS measures (r = −0.2431, p = 0.1306). Conclusion: Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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16 pages, 11528 KiB

Open AccessArticle

Network-Based Assessment of Minimal Change Disease Identifies Glomerular Response to IL-7 and IL-12 Pathways Activation as Innovative Treatment Target

by Øystein Eikrem, Bjørnar Lillefosse, Nicolas Delaleu, Philipp Strauss, Tarig Osman, Bjørn Egil Vikse, Hanna Debiec, Pierre Ronco, Miroslav Sekulic, Even Koch, Jessica Furriol, Sabine Maria Leh and Hans-Peter Marti

Biomedicines 2023, 11(1), 226; https://doi.org/10.3390/biomedicines11010226 - 16 Jan 2023

Cited by 4 | Viewed by 3041

Abstract

Background: Minimal change disease (MCD), a major cause of nephrotic syndrome, is usually treated by corticosteroid administration. MCD unresponsiveness to therapy and recurrences are nonetheless frequently observed, particularly in adults. To explore MCD-related pathogenetic mechanisms and to identify novel drug targets ultimately contributing to novel therapeutic avenues with a certain specificity for MCD, we compared glomerular transcriptomes from MCD with membranous nephropathy (MN) patients and healthy controls. Methods: Renal biopsies from adult patients with MCD (n = 14) or MN (n = 12), and non-diseased controls (n = 8) were selected from the Norwegian Kidney Biopsy Registry. RNA for 75 base-pair paired-end RNASeq were obtained from laser capture micro-dissected (LCM) glomeruli from FFPE sections. Transcriptional landscapes were computed by combining pathway-centered analyses and network science methodologies that integrate multiple bioinformatics resources. Results: Compared to normal glomeruli, cells from MCD displayed an inflammatory signature apparently governed by the IL1 and IL7 systems. While enrichment of IL1 production and secretion was a shared feature of MCD and MN compared to normal tissue, responses involving IL7 pathway activation were unique to MCD. Indeed, IL7R expressed by glomeruli was the most upregulated gene of the interleukin family in MCD versus normal controls. IL7 pathway activation was paralleled by significant enrichment in adaptive immune system processes and transcriptional regulation and depletion in pathways related to energy metabolism and transcription. Downregulation of these organ function-related themes again occurred predominately in MCD and was significantly less pronounced in MN. Immunofluorescence and immunohistochemistry, respectively, confirmed the expression of phosphorylated IL-7 receptor alpha (IL7RA, CD127) and IL12 receptor beta 1 (IL12RB1) proteins. Conclusions: Gene expression profiling of archival FFPE-biopsies identifies MCD-specific signatures with IL7RA and IL12RB1 as novel targets for MCD treatment. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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17 pages, 5987 KiB

Open AccessArticle

Variational Approach for Joint Kidney Segmentation and Registration from DCE-MRI Using Fuzzy Clustering with Shape Priors

by Moumen El-Melegy, Rasha Kamel, Mohamed Abou El-Ghar, Norah S. Alghamdi and Ayman El-Baz

Biomedicines 2023, 11(1), 6; https://doi.org/10.3390/biomedicines11010006 - 21 Dec 2022

Cited by 4 | Viewed by 1801

Abstract

The dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technique has great potential in the diagnosis, therapy, and follow-up of patients with chronic kidney disease (CKD). Towards that end, precise kidney segmentation from DCE-MRI data becomes a prerequisite processing step. Exploiting the useful information about the kidney’s shape in this step mandates a registration operation beforehand to relate the shape model coordinates to those of the image to be segmented. Imprecise alignment of the shape model induces errors in the segmentation results. In this paper, we propose a new variational formulation to jointly segment and register DCE-MRI kidney images based on fuzzy c-means clustering embedded within a level-set (LSet) method. The image pixels’ fuzzy memberships and the spatial registration parameters are simultaneously updated in each evolution step to direct the LSet contour toward the target kidney. Results on real medical datasets of 45 subjects demonstrate the superior performance of the proposed approach, reporting a Dice similarity coefficient of 0.94 ± 0.03, Intersection-over-Union of 0.89 ± 0.05, and 2.2 ± 2.3 in 95-percentile of Hausdorff distance. Extensive experiments show that our approach outperforms several state-of-the-art LSet-based methods as well as two UNet-based deep neural models trained for the same task in terms of accuracy and consistency. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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11 pages, 1111 KiB

Open AccessArticle

Non-Invasive Evaluation of Kidney Elasticity and Viscosity in a Healthy Cohort

by Felix-Mihai Maralescu, Felix Bende, Ioan Sporea, Alina Popescu, Roxana Sirli, Adalbert Schiller, Ligia Petrica, Bogdan Miutescu, Andreea Borlea, Alexandru Popa, Madalina Bodea and Flaviu Bob

Biomedicines 2022, 10(11), 2859; https://doi.org/10.3390/biomedicines10112859 - 8 Nov 2022

Cited by 8 | Viewed by 1929

Abstract

Introduction: There is currently a lack of published data on kidney elasticity and viscosity. Non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE PLUS) and viscosity plane-wave ultrasound (Vi PLUS), have surfaced as new detection methods, which, thanks to efficient processing software, are expected to improve renal stiffness and viscosity measurements. This study aims to be the first one to assess the normal range values in normal renal function subjects and to investigate the factors that impact them. Methods: We conducted a cross-sectional study employing 50 participants (29 women and 21 men) with a mean age of 42.22 ± 13.17, a mean estimated glomerular filtration rate (eGFR) of 97.12 ± 11 mL/min/1.73 m², a mean kidney length of 10.16 ± 0.66 cm, and a mean body mass index (BMI) of 24.24 ± 3.98. With a C6-1X convex transducer and the Ultra-FastTM software available on the Hologic Aixplorer Mach 30 ultrasound system, we acquired five measurements of renal cortical stiffness and viscosity (achieved from five distinct images in the middle part of the subcapsular cortex) from each kidney. The ten measurements’ median values correlated with the participant’s demographical, biological, and clinical parameters. Results: The mean kidney elasticity was 31.88 ± 2.89 kiloPascal (kPa), and the mean viscosity was 2.44 ± 0.57 Pascal.second (Pa.s) for a mean measurement depth 4.58 ± 1.02 cm. Renal stiffness seemed to be influenced by age (r = −0.7047, p < 0.0001), the measurement depth (r = −0.3776, p = 0.0075), and eGFR (r = 0.6101, p < 0.0001) but not by BMI (r = −0.2150, p = 0.1338), while viscosity appeared to be impacted by age (r = −0.4251, p = 0.0021), eGFR (r = 0.4057, p = 0.0038), the measurement depth (r = −0.4642, p = 0.0008), and BMI (r = −0.3676, p = 0.0086). The results of the one-way ANOVA used to test the differences in the variables among the three age sub-groups are statistically significant for both 2D-SWE PLUS (p < 0.001) and Vi PLUS (p = 0.015). The method found good intra-operator reproducibility for the 2D-SWE PLUS measurements, with an ICC of 0.8365 and a 95% CI of 0.7512 to 0.8990, and for the Vi PLUS measurements, with an ICC of 0.9 and a 95% CI of 0.8515 to 0.9397. Conclusions: Renal stiffness and viscosity screening may become an efficacious, low-cost way to gather supplemental diagnostic data from patients with chronic kidney disease (CKD). The findings demonstrate that these non-invasive methods are highly feasible and not influenced by gender and that their values correlate with renal function and decrease with age progression. Nevertheless, more research is required to ascertain their place in clinical practice. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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13 pages, 8033 KiB

Open AccessArticle

Characteristics of SARS-CoV-2 Infection in an Actively Monitored Cohort of Patients with Lupus Nephritis

by Bogdan Obrișcă, Alexandra Vornicu, Roxana Jurubiță, Valentin Mocanu, George Dimofte, Andreea Andronesi, Bogdan Sorohan, Camelia Achim, Georgia Micu, Raluca Bobeică, Constantin Dina and Gener Ismail

Biomedicines 2022, 10(10), 2423; https://doi.org/10.3390/biomedicines10102423 - 28 Sep 2022

Cited by 2 | Viewed by 2003

Abstract

(1) Background: We sought to investigate the impact of the COVID-19 pandemic in patients with lupus nephritis (LN); (2) Methods: A total of 95 patients with LN actively monitored in our department between 26 February 2020, when the first case of COVID-19 was diagnosed in Romania, and 1 May 2021, were included in the study. Multivariate logistic regression analysis was performed to identify the independent risk factors for SARS-CoV-2 infection; (3) Results: A total of 15 patients (15.8%) had a confirmed SARS-CoV-2 infection during a total follow-up time of 105.9 patient-years (unadjusted incidence rate: 14.28 SARS-CoV-2 infections per 100 patient-years). Median time to SARS-CoV-2 infection was 9.3 months (IQR: 7.2–11.3). The majority of patients had a mild form of SARS-CoV-2 infection (73.3%), while the remaining had moderate forms. None of the patients had a severe infection or a SARS-CoV-2-related death. The most frequent symptom was fatigue (73.3%), followed by loss of taste/smell (53.3%) and fever (46.7%). Forty percent of those with SARS-CoV-2 infection were hospitalized for a median 11.5 days (IQR:3.75–14). In the multivariate logistic regression analysis, a current oral corticosteroid dose ≥ 15 mg/day was associated with a 7.69-fold higher risk (OR, 7.69; 95%, 1.3–45.46), while the use of hydroxychloroquine was associated with a 91% lower risk for a SARS-CoV-2 infection (OR, 0.09; 95%CI, 0.01–0.59). (4) Conclusions: Our study confirms that the SARS-CoV-2 infection-associated morbidity might only be moderately increased in patients with LN. The current oral corticosteroid dose was the only independent predictor of infection occurrence, while use of hydroxychloroquine was associated with a protective effect. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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22 pages, 1194 KiB

Open AccessReview

The Potential Influence of Uremic Toxins on the Homeostasis of Bones and Muscles in Chronic Kidney Disease

by Kuo-Chin Hung, Wei-Cheng Yao, Yi-Lien Liu, Hung-Jen Yang, Min-Tser Liao, Keong Chong, Ching-Hsiu Peng and Kuo-Cheng Lu

Biomedicines 2023, 11(7), 2076; https://doi.org/10.3390/biomedicines11072076 - 24 Jul 2023

Cited by 4 | Viewed by 2532

Abstract

Patients with chronic kidney disease (CKD) often experience a high accumulation of protein-bound uremic toxins (PBUTs), specifically indoxyl sulfate (IS) and p-cresyl sulfate (pCS). In the early stages of CKD, the buildup of PBUTs inhibits bone and muscle function. As CKD progresses, elevated PBUT levels further hinder bone turnover and exacerbate muscle wasting. In the late stage of CKD, hyperparathyroidism worsens PBUT-induced muscle damage but can improve low bone turnover. PBUTs play a significant role in reducing both the quantity and quality of bone by affecting osteoblast and osteoclast lineage. IS, in particular, interferes with osteoblastogenesis by activating aryl hydrocarbon receptor (AhR) signaling, which reduces the expression of Runx2 and impedes osteoblast differentiation. High PBUT levels can also reduce calcitriol production, increase the expression of Wnt antagonists (SOST, DKK1), and decrease klotho expression, all of which contribute to low bone turnover disorders. Furthermore, PBUT accumulation leads to continuous muscle protein breakdown through the excessive production of reactive oxygen species (ROS) and inflammatory cytokines. Interactions between muscles and bones, mediated by various factors released from individual tissues, play a crucial role in the mutual modulation of bone and muscle in CKD. Exercise and nutritional therapy have the potential to yield favorable outcomes. Understanding the underlying mechanisms of bone and muscle loss in CKD can aid in developing new therapies for musculoskeletal diseases, particularly those related to bone loss and muscle wasting. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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21 pages, 2766 KiB

Open AccessReview

Oxalate Homeostasis in Non-Stone-Forming Chronic Kidney Disease: A Review of Key Findings and Perspectives

by Natalia Stepanova

Biomedicines 2023, 11(6), 1654; https://doi.org/10.3390/biomedicines11061654 - 7 Jun 2023

Cited by 8 | Viewed by 5577

Abstract

Chronic kidney disease (CKD) is a significant global public health concern associated with high morbidity and mortality rates. The maintenance of oxalate homeostasis plays a critical role in preserving kidney health, particularly in the context of CKD. Although the relationship between oxalate and kidney stone formation has been extensively investigated, our understanding of oxalate homeostasis in non-stone-forming CKD remains limited. This review aims to present an updated analysis of the existing literature, focusing on the intricate mechanisms involved in oxalate homeostasis in patients with CKD. Furthermore, it explores the key factors that influence oxalate accumulation and discusses the potential role of oxalate in CKD progression and prognosis. The review also emphasizes the significance of the gut–kidney axis in CKD oxalate homeostasis and provides an overview of current therapeutic strategies, as well as potential future approaches. By consolidating important findings and perspectives, this review offers a comprehensive understanding of the present knowledge in this field and identifies promising avenues for further research. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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12 pages, 480 KiB

Open AccessReview

Opportunities and Challenges of Human IPSC Technology in Kidney Disease Research

by Jia-Jung Lee, Chuang-Yu Lin, Hung-Chun Chen, Patrick C. H. Hsieh, Yi-Wen Chiu and Jer-Ming Chang

Biomedicines 2022, 10(12), 3232; https://doi.org/10.3390/biomedicines10123232 - 12 Dec 2022

Cited by 2 | Viewed by 2020

Abstract

Human induced pluripotent stem cells (iPSCs), since their discovery in 2007, open a broad array of opportunities for research and potential therapeutic uses. The substantial progress in iPSC reprogramming, maintenance, differentiation, and characterization technologies since then has supported their applications from disease modeling and preclinical experimental platforms to the initiation of cell therapies. In this review, we started with a background introduction about stem cells and the discovery of iPSCs, examined the developing technologies in reprogramming and characterization, and provided the updated list of stem cell biobanks. We highlighted several important iPSC-based research including that on autosomal dominant kidney disease and SARS-CoV-2 kidney involvement and discussed challenges and future perspectives. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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11 pages, 1204 KiB

Open AccessReview

Periostin as a Biomarker in the Setting of Glomerular Diseases—A Review of the Current Literature

by Nicolae Pană and Cristina Căpușă

Biomedicines 2022, 10(12), 3211; https://doi.org/10.3390/biomedicines10123211 - 10 Dec 2022

Cited by 1 | Viewed by 1849

Abstract

Chronic kidney disease (CKD) is a highly prevalent and potential progressive condition with life-threatening consequences. Glomerular diseases (glomerulopathies) are causes of CKD that are potentially amenable by specific therapies. Significant resources have been invested in the identification of novel biomarkers of CKD progression and new targets for treatment. By using experimental models of kidney diseases, periostin has been identified amongst the most represented matricellular proteins that are commonly involved in the inflammation and fibrosis that characterize progressive kidney diseases. Periostin is highly expressed during organogenesis, with scarce expression in mature healthy tissues, but it is upregulated in multiple disease settings characterized by tissue injury and remodeling. Periostin was the most highly expressed matriceal protein in both animal models and in patients with glomerulopathies. Given that periostin is readily secreted from injury sites, and the variations in its humoral levels compared to the normal state were easily detectable, its potential role as a biomarker is suggested. Moreover, periostin expression was correlated with the degree of histological damage and with kidney function decline in patients with CKD secondary to both inflammatory (IgA nephropathy) and non-inflammatory (membranous nephropathy) glomerulopathies, while also displaying variability secondary to treatment response. The scope of this review is to summarize the existing evidence that supports the role of periostin as a novel biomarker in glomerulopathies. Full article

(This article belongs to the Special Issue Progress in the Pathogenesis, Diagnosis and Treatment of Chronic Kidney Disease)

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