Department of Microbiology, College of Medicine, Howard University, Washington, District of Columbia, USA.
Center for Sickle Cell Disease, College of Medicine, Howard University, Washington, District of Columbia, USA.
Am J Nephrol. 2021;52(7):582-587. doi: 10.1159/000517056. Epub 2021 Aug 10.
Chronic kidney disease (CKD) is a prevalent complication of sickle cell anemia (SCA). Hyperfiltration that delayed detection of CKD is common in SCA patients. Identification of novel urinary biomarkers correlating with glomerular filtration rates may help to detect and predict progression of renal disease.
Reanalysis of mass spectra of urinary samples obtained from University of Illinois at Chicago identified kringle domain-containing protein HGFL.
HGFL levels correlated with hyperfiltration, were significantly reduced at CKD stage 1 compared to stage 0, negatively correlated with progression of CKD and were suitable for differentiation of stage 1. Better prediction of CKD progression to stage 2 was observed for HGFL-based risk prediction compared to the estimated glomerular filtration rate (eGFR)-based prediction. Results from a Howard University patient cohort supported the utility of HGFL-based test for the differentiation of stage 1 of CKD.
Urinary HGFL may contribute additional information beyond eGFR and improve diagnosis of early-stage CKD in SCA patients.
慢性肾脏病(CKD)是镰状细胞贫血(SCA)的一种常见并发症。高滤过是 SCA 患者 CKD 检测延迟的常见原因。识别与肾小球滤过率相关的新型尿生物标志物可能有助于检测和预测肾脏疾病的进展。
对来自伊利诺伊大学芝加哥分校的尿液样本的质谱进行重新分析,鉴定出含kringle 结构域蛋白 HGFL。
HGFL 水平与高滤过相关,在 CKD 1 期与 0 期相比显著降低,与 CKD 的进展呈负相关,并且适合于 1 期的区分。与基于估计肾小球滤过率(eGFR)的预测相比,基于 HGFL 的风险预测对 CKD 进展至 2 期的预测更好。霍华德大学患者队列的结果支持基于 HGFL 的检测用于区分 CKD 1 期的效用。
尿 HGFL 可能提供 eGFR 以外的额外信息,并改善 SCA 患者早期 CKD 的诊断。