Does human ochratoxin A aggravate proteinuria in patients with chronic renal disease?
BACKGROUND
Ochratoxin A (OTA) is a nephrotoxic metabolite occurring in foodstuffs. In the last decade, OTA-induced nephropathy in man and animals have been confirmed by previous literature. The correlation between OTA and the severity of CRI and nephrotic syndrome was also researched. Therefore, this study was designed to determine whether OTA also played an important role in renal insufficiency of patients with chronic renal diseases in Taiwan.


METHODS
The patients in this study were divided into nonnephrotic syndrome and nephrotic syndrome groups, first, to look for the relation between urine protein and OTA. And then these patients were also divided into six groups: (I) patients with chronic glomerulonephritis; (II) patients with chronic interstitial nephritis; (III) patients with diabetes mellitus; (IV) patients with hypertension; (V) patients with other diseases; (VI) patients with unknown reasons. For all groups, laboratory evaluation of kidney such as serum creatinine, urinary creatinine, creatinine clear rate, urinary protein, and urinary analysis were carried out coupled with determination of ochratoxin A level in urine.


RESULTS
Higher levels of OTA were found in patients with nephrotic syndrome. There was a significantly positive correlation (P<0.001) between 24-hr OTA and 24-hr urine protein. On the other hand, the mean excretion of OTA in DM group (group III) was found significantly higher compared to the other groups (P<0.05). Distinct differences (P<0.01) were found especially when DM group was compared with patients with chronic glomerulonephritis (group I; P=0.0019), patients with chronic interstitial nephritis (group II; P=0.0032) and patients with hypertension (group IV; P=0.0062).


CONCLUSIONS
The results could lead to the conclusion that OTA could play an important role in proteinuria of patients with chronic renal diseases in Taiwan. And OTA may play a role in diabetes patients with nephropathy. Further longitudinal study is needed to clarify the role of OTA in diabetic nephropathy.
Hsieh
Ming-Fang
MF
Department of Medicine, Chang Gung University, School of Medicine, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyan, Taiwan, ROC.
Chiu
Hsiao-Ying
HY
Lin-Tan
Dan-Tzu
DT
Lin
Ja-Liang
JL
D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000652:urine; D008297:Male; D008875:Middle Aged; D009183:Mycotoxins / Q000302:isolation & purification / Q000633:toxicity*; D009404:Nephrotic Syndrome / Q000652:urine; D009793:Ochratoxins / Q000302:isolation & purification / Q000633:toxicity*; D011507:Proteinuria / Q000139:chemically induced*; D013624:Taiwan
D009183:Mycotoxins; D009793:Ochratoxins; C025589:ochratoxin A