Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
and Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Hochsteiermark, Leoben, Austria.
Clin Chem Lab Med. 2020 Oct 13;59(3):563-570. doi: 10.1515/cclm-2020-0894. Print 2021 Feb 23.
The mucoprotein uromodulin is considered to correlate with glomerular filtration rates (GFR) in patients with chronic kidney disease (CKD). Here we investigated how serum uromodulin is associated with measured GFR using inulin-clearance and GFR estimated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation in healthy subjects.
We assessed possible correlations between uromodulin serum concentrations, inulin-GFR and CKD-EPI-GFR in a well characterized study cohort of 112 healthy living kidney donors with two kidneys before and 64 with one kidney after kidney donation. A subgroup of 32 individuals, which presented data before and after nephrectomy, was assessed separately.
All 112 healthy living kidney donors with two kidneys revealed individual serum uromodulin concentrations between 60.1 and 450.5 µg/L. Sixty-four healthy kidney donors after nephrectomy had significantly lower median (interquartile range) serum uromodulin concentrations (124 [101-166] vs. 185 [152-238] µg/L), inulin-GFR (67.3 [60.6-74.6] vs. 93.5 [82.1-104.4] mL/min/1.73 m), and CKD-EPI-GFR (61.2 [53.1-69.7] vs. 88.6 [80.0-97.1] mL/min/1.73 m) as compared to the 112 donors before donation (p<0.001). The subgroup of 32 subjects, which presented data before and after nephrectomy, showed almost the same pattern of kidney function. No statistically relevant associations were found between serum uromodulin and inulin-GFR or CKD-EPI-GFR regarding this healthy population.
These novel findings indicate that - in contrast to patients with CKD - serum uromodulin concentrations are not correlated with measured and estimated GFR in healthy individuals.
黏蛋白尿调素被认为与慢性肾脏病(CKD)患者的肾小球滤过率(GFR)相关。在这里,我们研究了健康受试者中使用菊粉清除率和 CKD-EPI(慢性肾脏病流行病学合作)方程估计的 GFR 时,血清尿调素与测量的 GFR 之间的关系。
我们在一项特征明确的研究队列中评估了 112 名健康活体供肾者的血清尿调素浓度、菊粉-GFR 和 CKD-EPI-GFR 之间的可能相关性,这些供肾者在捐肾前有两个肾脏,64 人在捐肾后只有一个肾脏。单独评估了一个由 32 名个体组成的亚组,这些个体提供了肾切除术前和术后的数据。
112 名健康活体供肾者的血清尿调素浓度个体差异为 60.1-450.5µg/L。64 名肾切除术后的健康供肾者的血清尿调素浓度中位数(四分位距)显著降低(124[101-166]vs.185[152-238]µg/L),菊粉-GFR(67.3[60.6-74.6]vs.93.5[82.1-104.4]mL/min/1.73m)和 CKD-EPI-GFR(61.2[53.1-69.7]vs.88.6[80.0-97.1]mL/min/1.73m)与捐肾前的 112 名供肾者相比(p<0.001)。在肾切除术前和术后提供数据的 32 名个体亚组显示出几乎相同的肾功能模式。在这个健康人群中,血清尿调素与菊粉-GFR 或 CKD-EPI-GFR 之间没有发现统计学上的相关关系。
这些新发现表明,与 CKD 患者不同,血清尿调素浓度与健康个体的测量和估计的 GFR 无关。