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Assessment of Cystatin C-Based GFR Estimating Equations as a Novel Reliable Biomarker for Renal Pathology Diagnosis in Patients with Mild to Severe Tubular Affection

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Open Journal of Nephrology 2022年第4期12卷 426-440页

作者： Mohamed Ali Ibrahim Norhan Nagdi cherry reda kamel Nephrology Department Faculty of Medicine Ain Shams University Cairo Egypt

Background and Objective: Serum creatinine, a commonly used biomarker in determining glomerular filtration rate (GFR) and chronic kidney disease (CKD) stage, is highly variable biologically and does not rise until > 50% of renal function (RF) impairment occurs. Also, its production is not constant & is affected by many factors as muscle mass, age, inflammation. On the other hand, Cystatin C shows more stable production making it more suitable for assessment of kidney function. Also, It has been shown that the progression of CKD to renal failure, even in glomerular diseases, correlated better with the degree of tubular damage and interstitial fibrosis. So, our aim was to investigate the relation between kidney function assessed by different cystatin (Cys-C)-based estimated glomerular filtration rate (eGFR) in comparison to the gold standard Iohexol (Ioh) based measured (m)GFR in relation to the pathological degree of tubular damage in renal biopsy. To our knowledge, this is the first study that evaluates the relation of (Cys-C)-based eGFR to tubulointerstitial fibrosis in renal biopsy. Methods: This cross-sectional study was performed on 20 CKD cases who attended the Nephrology Department at Ain Shams University, where a renal biopsy was obtained, and individuals were allocated into two groups: group A (GA) with mild tubular affection (TA) and group B (GB) with moderate to severe TA. All participants were referred for measure-ment of GFR using Iohexol (Ioh) together with serum Cys-C level and eGFR was calculated using different Cys-C-based GFR estimating equations, which were further compared using Multivariate Linear Regression and Bland-Altman analyses. Results: Our results revealed a substantial statistical difference among the two studied groups regarding Hb, s creatinine, urea. GB had significantly lower levels for both eGFR and mGFR (82, 93, 115, or 115) ml/min/1.73m2, Vs. GA (200, 123, 162 or 124) ml/min/1.73m2, according to GFR_iohexol,

关键词： Cystatin C Chronic Kidney Diseases Glomerular Filtration Rate Iohexol Clearance

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Changes of MicroRNA-377 in Diabetic Nephropathy

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Open Journal of Nephrology 2022年第3期12卷 347-360页

作者： Howayda Abdul Hamid El Shinnawy Mervat Hussein Ahmed Elkeleng cherry reda kamel Internal Medicine and Nephrology Ain Shams University Cairo Egypt

Background: MicroRNAs (miRNAs) play important roles in modulating gene expression. In cultured mesangial cells, MiR-377 exhibited the greatest change on exposure to high glucose and led to increased fibronectin production in in-vitro diabetic nephropathy. Our aim was to identify the pattern of microRNA-377 changes in human diabetic patients with different stages of diabetic nephropathy. Methods: The study included 45 patients divided into 5 groups;patients with stage 1 & 2 diabetic nephropathy (DN), stage 3 & 4 DN, diabetics without DN, stage 1 & 2 chronic kidney disease (CKD), and stage 3 & 4 CKD. The following tests were done to all patients;serum creatinine, estimated glomerular filtration rate (eGFR), albumin to creatinine ratio, blood sugar, urine analysis, glycated hemoglobin, fundus examination. The RNA was extracted from plasma samples, TaqMan microRNA (miRNA) assays from applied Bio systems were used for analysis of MicroRNA-377. Results: This study found that patients with the highest median of the interquartile range (IQR) of miR-377 were those of group 1 with significant difference between them and all other groups. MiR-377 was significantly correlated with glycated hemoglobin but not with eGFR. Conclusion: Plasma miR-377 is highly significantly increased in human diabetic patients with early rather than late diabetic nephropathy, diabetics without nephropathy, or those at any stage of other causes of CKD. Our findings confirm the role of miR-377 as a potentially novel target in the development of diabetic nephropathy in humans.

关键词： MicroRNA MiR-377 Diabetic Nephropathy Chronic Kidney Disease

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Changes of MicroRNA-377 in Diabetic Nephropathy

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Open Journal of Nephrology（肾脏病） 2022年第3期

作者： howayda abdul hamid el shinnawy mervat hussein ahmed elkeleng cherry reda kamel

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