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Proteinuria and tubular cells: Plasticity and toxicity.
Acta Physiol (Oxf)
February 2025
Department of Medicine, Cell Physiology and Metabolism, University of Geneva, Geneva, Switzerland.
Aim: Proteinuria is the most robust predictive factors for the progression of chronic kidney disease (CKD), and interventions targeting proteinuria reduction have shown to be the most effective nephroprotective treatments to date. While glomerular dysfunction is the primary source of proteinuria, its consequences extend beyond the glomerulus and have a profound impact on tubular epithelial cells. Indeed, proteinuria induces notable phenotypic changes in tubular epithelial cells and plays a crucial role in driving CKD progression.
View Article and Find Full Text PDFProtein handling in kidney tubules.
Nat Rev Nephrol
January 2025
Institute of Anatomy, University of Zurich, Zurich, Switzerland.
The kidney proximal tubule reabsorbs and degrades filtered plasma proteins to reclaim valuable nutrients and maintain body homeostasis. Defects in this process result in proteinuria, one of the most frequently used biomarkers of kidney disease. Filtered proteins enter proximal tubules via receptor-mediated endocytosis and are processed within a highly developed apical endo-lysosomal system (ELS).
View Article and Find Full Text PDFAlterations in gut-derived uremic toxins before the onset of azotemic chronic kidney disease in cats.
J Vet Intern Med
December 2024
Faculty of Veterinary Medicine, Department of Small Animals, Ghent University, Merelbeke, Belgium.
Background: Although gut-derived uremic toxins are increased in azotemic chronic kidney disease (CKD) in cats and implicated in disease progression, it remains unclear if augmented formation or retention of these toxins is associated with the development of renal azotemia.
Objectives: Assess the association between gut-derived toxins (ie, indoxyl-sulfate, p-cresyl-sulfate, and trimethylamine-N-oxide [TMAO]) and the onset of azotemic CKD in cats.
Animals: Forty-eight client-owned cats.
Methods for Diagnosing Proteinuria: When to Use Which Test, and Why.
Am J Kidney Dis
December 2024
Medical Outpatient Department, University Hospital Basel, University Basel, Switzerland. Electronic address:
Proteinuria plays a central role in the diagnosis of kidney disease and has a high prognostic value. The test methods used differ considerably regarding impact on test accuracy, sensitivity, and specificity. Therefore, knowledge of the methodology is crucial for the interpretation of the results.
View Article and Find Full Text PDFA liver transplant patient developed renal injury on tacrolimus and experienced worsening renal function and rhabdomyolysis after switching to sirolimus: a case report.
BMC Nephrol
December 2024
Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, 610041, China.
Article Synopsis
- A 54-year-old male liver transplant patient initially treated with tacrolimus developed renal dysfunction, prompting a switch to sirolimus for immunosuppression.
- After starting sirolimus, the patient experienced worsening renal function and later developed rhabdomyolysis, linked to high sirolimus levels in serum and specific kidney damage seen in histopathology.
- Reducing the sirolimus dosage led to normalization of muscle enzyme levels and improved kidney function, emphasizing the need for careful monitoring of sirolimus concentrations to prevent such serious side effects.
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