Urinary kallikrein excretion is related to renal function change and inflammatory status in chronic kidney disease patients receiving angiotensin II receptor blocker treatment.
OBJECTIVE
This study was to evaluate the correlation of urinary kallikrein to renal function, proteinuria and urinary cytokines in chronic kidney disease patients in a longitudinal follow up.


METHODS
We measured urinary kallikrein and cytokines in 50 patients who were followed up for 12 months.


RESULTS
Using regression model we found that the kallikrein excretion (estimated by log kallikrein/creatinine) was positively correlated to log estimated glomerular filtration rate in the beginning and the end of follow up (P = 0.049 and 0.006, respectively). No correlation existed between kallikrein excretion and proteinuria. The kallikrein excretion decreased after 12 months of follow up, which was also associated with the decrease of log estimated glomerular filtration rate. There was a significant positive correlation between the log urinary kallikrein and monocyte chemoattractant protein-1 (MCP-1) concentration (correlation coefficient = 0.277; P = 0.049). Urinary kallikrein excretion was also positively correlated with serum MCP-1 level (correlation coefficient = 0.431; P = 0.002). No correlation existed between urinary kallikrein and transforming growth factor beta-1 or tumour necrosis factor-alpha concentration.


CONCLUSIONS
Urinary kallikrein excretion is positively correlated to renal function, serum and urinary inflammatory mediator MCP-1 in chronic kidney disease patients. These findings indicate that urinary kallikrein excretion may reflect the change of renal function and kidney inflammatory status.
Chiang
Wen-Chih
WC
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Lin
Shuei-Liong
SL
Chen
Yung-Ming
YM
Wu
Kwan-Dun
KD
Tsai
Tun-Jun
TJ
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D015415:Biomarkers / Q000652:urine; D018932:Chemokine CCL2 / Q000652:urine; D016207:Cytokines / Q000097:blood / Q000652:urine*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood / Q000652:urine*; D007610:Kallikreins / Q000652:urine*; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors; D053773:Transforming Growth Factor beta1 / Q000652:urine; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000652:urine
D047228:Angiotensin II Type 1 Receptor Blockers; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D016207:Cytokines; D018836:Inflammation Mediators; D053773:Transforming Growth Factor beta1; D014409:Tumor Necrosis Factor-alpha; D007610:Kallikreins; D019808:Losartan