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Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis.
Crit Care Res Pract 2019; 2019:5912804CC

Abstract

Background

Acute kidney injury (AKI) is a frequent complication of decompensated cirrhosis with increased mortality. Traditional biomarkers such as serum creatinine are not sensitive for detecting injury without functional change. We hypothesize that urinary exosomes potentially carry markers that differentiate the type of kidney injury in cirrhotic patients.

Methods

This is a prospective, single-center, and observational study of adult patients with cirrhosis. The patient groups included healthy normal controls, compensated cirrhosis with normal kidney function, decompensated cirrhosis with normal kidney function, and decompensated cirrhosis with AKI. Data were extracted from the electronic health record including etiology of liver disease, MELD score, history of decompensation, Child-Turcotte-Pugh score, history of AKI, and medication exposures. Urine samples were collected at the time of consent. Urine exosome protein content was analyzed, and proteomic data were validated by immunoblotting. Statistical analysis included partial least squares-discriminant analysis coupled with variable importance in projection identification.

Results

Eighteen cirrhotic subjects were enrolled, and six healthy control subjects were extracted from our biorepository. Urine exosomes were isolated, and 1572 proteins were identified. Maltase-glucoamylase was the top discriminating protein confirmed by western blotting.

Conclusions

Patients with cirrhosis and AKI have upregulation of renal brush border disaccharidase, MGAM, in urinary exosomes which may differentiate the type of kidney injury in cirrhosis; however, the clinical significance of this requires further validation.

Authors+Show Affiliations

UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, USA. Biomarkers Laboratory, O'Brien Center for Acute Kidney Injury Research, Nephrology-Hypertension, UC San Diego, Department of Medicine, San Diego, USA.UC San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, USA.UC San Diego, Department of Medicine, Division of Gastroenterology, San Diego, USA.Biomarkers Laboratory, O'Brien Center for Acute Kidney Injury Research, Nephrology-Hypertension, UC San Diego, Department of Medicine, San Diego, USA.UC San Diego, Department of Chemistry & Biochemistry, Biomolecular & Proteomics Spectrometry Facility, San Diego, USA.UC San Diego, Departments of Medicine, Pediatrics and Pathology, San Diego, USA.UC San Diego, Department of Medicine, Division of Gastroenterology, San Diego, USA.Biomarkers Laboratory, O'Brien Center for Acute Kidney Injury Research, Nephrology-Hypertension, UC San Diego, Department of Medicine, San Diego, USA.I-AIM Biomarkers Laboratory, The University of Trans-Disciplinary Health Sciences and Technology (TDU), Bangalore, India.Biomarkers Laboratory, O'Brien Center for Acute Kidney Injury Research, Nephrology-Hypertension, UC San Diego, Department of Medicine, San Diego, USA. I-AIM Biomarkers Laboratory, The University of Trans-Disciplinary Health Sciences and Technology (TDU), Bangalore, India. UC San Diego, Department of Medicine, Division of Infectious Diseases, San Diego, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31179128

Citation

Awdishu, Linda, et al. "Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients With Cirrhosis." Critical Care Research and Practice, vol. 2019, 2019, p. 5912804.
Awdishu L, Tsunoda S, Pearlman M, et al. Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis. Crit Care Res Pract. 2019;2019:5912804.
Awdishu, L., Tsunoda, S., Pearlman, M., Kokoy-Mondragon, C., Ghassemian, M., Naviaux, R. K., ... RamachandraRao, S. P. (2019). Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis. Critical Care Research and Practice, 2019, p. 5912804. doi:10.1155/2019/5912804.
Awdishu L, et al. Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients With Cirrhosis. Crit Care Res Pract. 2019;2019:5912804. PubMed PMID: 31179128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of Maltase Glucoamylase as a Biomarker of Acute Kidney Injury in Patients with Cirrhosis. AU - Awdishu,Linda, AU - Tsunoda,Shirley, AU - Pearlman,Michelle, AU - Kokoy-Mondragon,Chanthel, AU - Ghassemian,Majid, AU - Naviaux,Robert K, AU - Patton,Heather M, AU - Mehta,Ravindra L, AU - Vijay,Bhavya, AU - RamachandraRao,Satish P, Y1 - 2019/04/16/ PY - 2018/10/30/received PY - 2018/12/31/revised PY - 2019/02/19/accepted PY - 2019/6/11/entrez PY - 2019/6/11/pubmed PY - 2019/6/11/medline SP - 5912804 EP - 5912804 JF - Critical care research and practice JO - Crit Care Res Pract VL - 2019 N2 - Background: Acute kidney injury (AKI) is a frequent complication of decompensated cirrhosis with increased mortality. Traditional biomarkers such as serum creatinine are not sensitive for detecting injury without functional change. We hypothesize that urinary exosomes potentially carry markers that differentiate the type of kidney injury in cirrhotic patients. Methods: This is a prospective, single-center, and observational study of adult patients with cirrhosis. The patient groups included healthy normal controls, compensated cirrhosis with normal kidney function, decompensated cirrhosis with normal kidney function, and decompensated cirrhosis with AKI. Data were extracted from the electronic health record including etiology of liver disease, MELD score, history of decompensation, Child-Turcotte-Pugh score, history of AKI, and medication exposures. Urine samples were collected at the time of consent. Urine exosome protein content was analyzed, and proteomic data were validated by immunoblotting. Statistical analysis included partial least squares-discriminant analysis coupled with variable importance in projection identification. Results: Eighteen cirrhotic subjects were enrolled, and six healthy control subjects were extracted from our biorepository. Urine exosomes were isolated, and 1572 proteins were identified. Maltase-glucoamylase was the top discriminating protein confirmed by western blotting. Conclusions: Patients with cirrhosis and AKI have upregulation of renal brush border disaccharidase, MGAM, in urinary exosomes which may differentiate the type of kidney injury in cirrhosis; however, the clinical significance of this requires further validation. SN - 2090-1305 UR - https://www.unboundmedicine.com/medline/citation/31179128/Identification_of_Maltase_Glucoamylase_as_a_Biomarker_of_Acute_Kidney_Injury_in_Patients_with_Cirrhosis L2 - https://dx.doi.org/10.1155/2019/5912804 DB - PRIME DP - Unbound Medicine ER -