title: Renal handling of galectin-3 in the general population, chronic heart failure, and hemodialysis.
abstract: BACKGROUND
  Galectin-3 is a biomarker for prognostication and risk stratification of patients with heart failure (HF). It has been suggested that renal function strongly relates to galectin-3 levels. We aimed to describe galectin-3 renal handling in HF.
  
  
  RESULTS
  In Sprague-Dawley rats, we infused galectin-3 and studied distribution and renal clearance. Furthermore, galectin-3 was measured in urine and plasma of healthy controls, HF patients and hemodialysis patients. To mimic the human situation, we measured galectin-3 before and after the artificial kidney. Infusion in rats resulted in a clear increase in plasma and urine galectin-3. Plasma galectin-3 in HF patients (n=101; mean age 64 years; 93% male) was significantly higher compared to control subjects (n=20; mean age 58 years; 75% male) (16.6 ng/mL versus 9.7 ng/mL, P<0.001), while urinary galectin-3 in HF patients was comparable (28.1 ng/mL versus 35.1 ng/mL, P=0.830). The calculated galectin-3 excretion rate was lower in HF patient (2.3 mL/min [1.5 to 3.4] versus 3.9 mL/min [2.3 to 6.4] in control subjects; P=0.005). This corresponded with a significantly lower fractional excretion of galectin-3 in HF patients (2.4% [1.7 to 3.7] versus 3.0% [1.9 to 5.5]; P=0.018). These differences, however, were no longer significant after correction for age, gender, diabetes, and smoking. HF patients who received diuretics (49%) showed significantly higher aldosterone and galectin-3 levels. Hemodialysis patients (n=105; mean age 63 years; 65% male), without urinary galectin-3 excretion, had strongly increased median plasma galectin-3 levels (70.6 ng/mL).
  
  
  CONCLUSIONS
  In this small cross-sectional study, we report that urine levels of galectin-3 are not increased in HF patients, despite substantially increased plasma galectin-3 levels. The impaired renal handling of galectin-3 in patients with HF may explain the described relation between renal function and galectin-3 and may account for the elevated plasma galectin-3 in HF.
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Wouter C
authors.initials: WC
authors.lastname: Meijers
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: A Rogier
authors.initials: AR
authors.lastname: van der Velde
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Willem P
authors.initials: WP
authors.lastname: Ruifrok
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schroten
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Martin M
authors.initials: MM
authors.lastname: Dokter
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Kevin
authors.initials: K
authors.lastname: Damman
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands (S.A., C.F.F., R.T.G.).
authors.forename: Solmaz
authors.initials: S
authors.lastname: Assa
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands (S.A., C.F.F., R.T.G.).
authors.forename: Casper F
authors.initials: CF
authors.lastname: Franssen
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands (S.A., C.F.F., R.T.G.).
authors.forename: Ron T
authors.initials: RT
authors.lastname: Gansevoort
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Herman H
authors.initials: HH
authors.lastname: Silljé
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, The Netherlands (W.C.M., R.V., W.P.R., N.F.S., M.M.D., K.D., W.H.G., H.H.S., R.A.B.).
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: de Boer
mesh_terms: D061605:Administration, Intravenous; D000818:Animals; D001798:Blood Proteins; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D037502:Galectin 3 / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism* / Q000493:pharmacokinetics / Q000652:urine; D037161:Galectins; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism*; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017207:Rats, Sprague-Dawley; D006435:Renal Dialysis; D065667:Renal Elimination
chemical_list: D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; C428445:LGALS3 protein, human
keywords: heart failure; kidney; remodeling