Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2017 Feb 27;7:43589. doi: 10.1038/srep43589.
Peroxiredoxin 3 (PRX3) is a mitochondrial antioxidant that regulates apoptosis in various cancers. However, whether tubular PRX3 predicts recovery of renal function following acute kidney injury (AKI) remains unknown. This retrospective cohort study included 54 hospitalized patients who had AKI with biopsy-proven acute tubular necrosis (ATN). The study endpoint was renal function recovery within 6 months. Of the 54 enrolled patients, 25 (46.3%) had pre-existing chronic kidney disease (CKD) and 33 (61%) recovered renal function. Tubular PRX3 expression was higher in patients with ATN than in those without renal function recovery. The level of tubular but not glomerular PRX3 expression predicted renal function recovery from AKI (AUROC = 0.76). In multivariate Cox regression analysis, high PRX3 expression was independently associated with a higher probability of renal function recovery (adjusted hazard ratio = 8.99; 95% CI 1.13-71.52, P = 0.04). Furthermore, the discriminative ability of the clinical model for AKI recovery was improved by adding tubular PRX3. High tubular PRX3 expression was associated with a higher probability of renal function recovery from ATN. Therefore, tubular PRX3 in combination with conventional predictors can further improve recovery prediction and may help with risk stratification in AKI patients with pre-existing CKD.
过氧化物酶 3（PRX3）是一种线粒体抗氧化剂，可调节多种癌症中的细胞凋亡。然而，管状 PRX3 是否可预测急性肾损伤（AKI）后肾功能的恢复尚不清楚。本回顾性队列研究纳入了 54 例经活检证实为急性肾小管坏死（ATN）的 AKI 住院患者。研究终点为 6 个月内肾功能的恢复情况。在纳入的 54 例患者中，25 例（46.3%）患有预先存在的慢性肾脏病（CKD），33 例（61%）肾功能恢复。ATN 患者的管状 PRX3 表达高于肾功能未恢复的患者。管状而非肾小球 PRX3 表达水平可预测 AKI 后肾功能的恢复（AUROC=0.76）。多变量 Cox 回归分析表明，高 PRX3 表达与肾功能恢复的可能性更高独立相关（调整后的危险比=8.99；95%CI 1.13-71.52，P=0.04）。此外，通过添加管状 PRX3，改善了 AKI 恢复临床模型的判别能力。高管状 PRX3 表达与 ATN 肾功能恢复的可能性更高相关。因此，管状 PRX3 与常规预测因子相结合可以进一步提高恢复预测能力，并有助于对预先存在 CKD 的 AKI 患者进行风险分层。
