title: Specific renal parenchymal-derived urinary extracellular vesicles identify age-associated structural changes in living donor kidneys.
abstract: Non-invasive tests to identify age and early disease-associated pathology within the kidney are needed. Specific populations of urinary extracellular vesicles (EVs) could potentially be used for such a diagnostic test. Random urine samples were obtained from age- and sex-stratified living kidney donors before kidney donation. A biopsy of the donor kidney was obtained at the time of transplantation to identify nephron hypertrophy (larger glomerular volume, cortex per glomerulus and mean profile tubular area) and nephrosclerosis (% fibrosis, % glomerulosclerosis and arteriosclerosis). Renal parenchymal-derived EVs in cell-free urine were quantified by digital flow cytometry. The relationship between these EV populations and structural pathology on the kidney biopsy was assessed. Clinical characteristics of the kidney donors (n=138, age range: 20-70 years, 50% women) were within the normative range. Overall, urine from women contained more EVs than that from men. The number of exosomes, juxtaglomerular cells and podocyte marker-positive EVs decreased (p<0.05) with increasing age. There were fewer total EVs as well as EVs positive for mesangial cell, parietal cell, descending limb of Henle's loop (simple squamous epithelium), collecting tubule-intercalated cell and monocyte chemoattractant protein-1 markers (p<0.05) in persons with nephron hypertrophy. The number of EVs positive for intercellular adhesion molecule-1, juxtaglomerular cell, podocyte, parietal cell, proximal tubular epithelial cell, distal tubular epithelial cell and collecting duct cells were fewer (p<0.05) in persons with nephrosclerosis. EVs carrying markers of cells from the renal pelvis epithelium did not associate with any indices of nephron hypertrophy or nephrosclerosis. Therefore, specific populations of EVs derived from cells of the glomerulus and nephron associate with underlying kidney structural changes. Further validation of these findings in other cohorts is needed to determine their clinical utility.
authors.affiliation: Department of Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Turco
authors.affiliation: Department of Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Wing
authors.initials: W
authors.lastname: Lam
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Rule
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Denic
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA.|Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Lieske
authors.affiliation: Department of Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN, USA.|Department of Surgery, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Miller
authors.affiliation: Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Larson
authors.affiliation: Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Walter K
authors.initials: WK
authors.lastname: Kremers
authors.affiliation: Department of Physiology & Biomedical Engineering, College of Medicine, Mayo Clinic, Rochester, MN, USA.|Department of Surgery, College of Medicine, Mayo Clinic, Rochester, MN, USA; jaya.m@mayo.edu.
authors.forename: Muthuvel
authors.initials: M
authors.lastname: Jayachandran
keywords: arteriosclerosis; exosomes; fibrosis; glomerulosclerosis; microparticles; microvesicles; nephron hypertrophy; urinary vesicles
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