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Öberg, Carl M.Lund University,Lunds universitet,Njurfysiologi och peritonealdialys,Forskargrupper vid Lunds universitet,Renal physiology and peritoneal dialysis,Lund University Research Groups,Skåne University Hospital
(författare)
Potential relationship between eGFRcystatin C /eGFRcreatinine -ratio and glomerular basement membrane thickness in diabetic kidney disease
- Artikel/kapitelEngelska2021
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LIBRIS-ID:oai:lup.lub.lu.se:9b514900-af3b-4f1a-8ca7-df4c2f9f2394
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https://lup.lub.lu.se/record/9b514900-af3b-4f1a-8ca7-df4c2f9f2394URI
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https://doi.org/10.14814/phy2.14939DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:art swepub-publicationtype
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Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease and renal replacement therapy worldwide. A pathophysiological hallmark of DKD is glomeru- lar basal membrane (GBM) thickening, whereas this feature is absent in minimal change disease (MCD). According to fundamental transport physiological principles, a thicker GBM will impede the diffusion of middle-molecules such as cystatin C, potentially leading to a lower estimated GFR (eGFR) from cystatin C compared to that of creatinine. Here we test the hypothesis that thickening of the glomerular filter leads to an increased diffusion length, and lower clearance, of cystatin C. Twenty- nine patients with a kidney biopsy diagnosis of either DKD (n = 17) or MCD (n = 12) were retrospectively included in the study. GBM thickness was measured at 20 sepa- rate locations in the biopsy specimen and plasma levels of cystatin C and creatinine were retrieved from health records. A modified two-pore model was used to simulate the effects of a thicker GBM on glomerular water and solute transport. The mean age of the patients was 52 years, and 38% were women. The mean eGFRcystatin C/ eGFRcreatinine-ratio was 74% in DKD compared to 98% in MCD (p < 0.001). Average GBM thickness was strongly inversely correlated to the eGFRcystatin C/eGFRcreatinine- ratio (Pearson's r = −0.61, p < 0.01). Two-pore modeling predicted a eGFRcystatin C/ eGFRcreatinine-ratio of 78% in DKD. We provide clinical and theoretical evidence sug- gesting that thickening of the glomerular filter, increasing the diffusion length of cys- tatin C, lowers the eGFRcystatin C/eGFRcreatinine-ratio in DKD.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Lindström, MartinLund University,Lunds universitet,Klinisk patologi, Malmö,Forskargrupper vid Lunds universitet,Clinical pathology, Malmö,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-ml11
(författare)
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Grubb, AndersLund University,Lunds universitet,Cystatin C, njursjukdom, amyloidos och antibiotika,Forskargrupper vid Lunds universitet,Cystatin C, renal disease, amyloidosis and antibiotics,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kkem-agr
(författare)
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Christensson, AndersLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)medf-ach
(författare)
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Njurfysiologi och peritonealdialysForskargrupper vid Lunds universitet
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Physiological Reports: Wiley2051-817X
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