title: The relationship between renal function and plasma concentration of the cachectic factor zinc-alpha2-glycoprotein (ZAG) in adult patients with chronic kidney disease.
abstract: Zinc-α2-glycoprotein (ZAG), a potent cachectic factor, is increased in patients undergoing maintenance dialysis. However, there is no data for patients before initiation of renal replacement therapy. The purpose of the present study was to assess the relationship between plasma ZAG concentration and renal function in patients with a large range of glomerular filtration rate (GFR). Plasma ZAG concentration and its relationship to GFR were investigated in 71 patients with a chronic kidney disease (CKD) stage 1 to 5, 17 chronic hemodialysis (HD), 8 peritoneal dialysis (PD) and 18 non-CKD patients. Plasma ZAG concentration was 2.3-fold higher in CKD stage 5 patients and 3-fold higher in HD and PD patients compared to non-CKD controls (P<0.01). The hemodialysis session further increased plasma ZAG concentration (+39%, P<0.01). An inverse relationship was found between ZAG levels and plasma protein (rs = -0.284; P<0.01), albumin (rs = -0.282, P<0.05), hemoglobin (rs = -0.267, P<0.05) and HDL-cholesterol (rs = -0.264, P<0.05) and a positive correlation were seen with plasma urea (rs = 0.283; P<0.01). In multiple regression analyses, plasma urea and HDL-cholesterol were the only variables associated with plasma ZAG (r2 = 0.406, P<0.001). In CKD-5 patients, plasma accumulation of ZAG was not correlated with protein energy wasting. Further prospective studies are however needed to better elucidate the potential role of ZAG in end-stage renal disease.
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.
authors: Caroline C
authors: CC
authors: Pelletier
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.
authors: Laetitia
authors: L
authors: Koppe
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.
authors: Pascaline M
authors: PM
authors: Alix
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.
authors: Emilie
authors: E
authors: Kalbacher
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France.
authors: Marine L
authors: ML
authors: Croze
authors: Université de Lyon, F-69600, Oullins, France; Hospices Civils de Lyon, Exploration Fonctionnelle Rénale et Métabolique, Hôpital E Herriot, Lyon, France.
authors: Aoumeur
authors: A
authors: Hadj-Aissa
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Centre Hospitalier Lyon-SUD, Pierre-Bénite, France.
authors: Denis
authors: D
authors: Fouque
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France; Hospices Civils de Lyon, Service de Néphrologie, Hôpital E Herriot, Lyon, France.
authors: Fitsum
authors: F
authors: Guebre-Egziabher
authors: Université de Lyon, F-69600, Oullins, France; INSERM, U1060, CarMeN, INSA-Lyon, Univ. Lyon-1, Villeurbanne, France.
authors: Christophe O
authors: CO
authors: Soulage
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy / Q000652:urine; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000175:diagnosis / Q000628:therapy / Q000652:urine*; D012307:Risk Factors; D029589:Seminal Plasma Proteins / Q000097:blood*; D012720:Severity of Illness Index; D000090203:Zn-Alpha-2-Glycoprotein
chemical_list: D029589:Seminal Plasma Proteins; D000090203:Zn-Alpha-2-Glycoprotein