BACKGROUND: Increased cell death in chronic kidney disease (CKD) by either necrosis or apoptosis has been confirmed by a variety of studies. Possible sources are an inadequate persistent inflammation and ischemia as a consequence of CKD or caused by the underlying renal disease. Detection of total or caspase cleaved cytokeratin 18 (CK-18) is a novel and elegant method to determine necrosis or apoptosis of epithelial cells in the patients' sera and urine. METHODS: 120 patients with CKD stages 1 to 5 were included in the study. Twenty healthy volunteers served as controls. Total and caspase cleaved CK-18 urine and serum concentrations were determined by ELISA. RESULTS: The concentration of serum total CK-18 was significantly higher in CKD stages 3-5 as compared to the healthy controls. Urinary total CK-18 excretion was increased in patients with CKD 5 compared to controls. A significant correlation between urine total CK18 and urine protein and albumin levels was found. Moreover, ROC curve analysis showed the potential of serum and especially urine total CK-18 levels to predict various CKD stages. CONCLUSIONS: We provide evidence for increased total CK-18 serum and urine levels in CKD patients, possibly indicating that epithelial cell necrosis is prevalent in CKD.
BACKGROUND: Increased cell death in chronic kidney disease (CKD) by either necrosis or apoptosis has been confirmed by a variety of studies. Possible sources are an inadequate persistent inflammation and ischemia as a consequence of CKD or caused by the underlying renal disease. Detection of total or caspase cleaved cytokeratin 18 (CK-18) is a novel and elegant method to determine necrosis or apoptosis of epithelial cells in the patients' sera and urine. METHODS: 120 patients with CKD stages 1 to 5 were included in the study. Twenty healthy volunteers served as controls. Total and caspase cleaved CK-18 urine and serum concentrations were determined by ELISA. RESULTS: The concentration of serum total CK-18 was significantly higher in CKD stages 3-5 as compared to the healthy controls. Urinary total CK-18 excretion was increased in patients with CKD 5 compared to controls. A significant correlation between urine total CK18 and urine protein and albumin levels was found. Moreover, ROC curve analysis showed the potential of serum and especially urine total CK-18 levels to predict various CKD stages. CONCLUSIONS: We provide evidence for increased total CK-18 serum and urine levels in CKD patients, possibly indicating that epithelial cell necrosis is prevalent in CKD.
Authors: Diana Lebherz-Eichinger; Bianca Tudor; Hendrik J Ankersmit; Thomas Reiter; Martin Haas; Franziska Roth-Walter; Claus G Krenn; Georg A Roth Journal: PLoS One Date: 2015-09-21 Impact factor: 3.240
Authors: Diana Lebherz-Eichinger; Bianca Tudor; Hendrik J Ankersmit; Thomas Reiter; Martin Haas; Elisa Einwallner; Franziska Roth-Walter; Claus G Krenn; Georg A Roth Journal: PLoS One Date: 2017-03-29 Impact factor: 3.240
Authors: Jian Cao; Ran Xu; Xiaokun Zhao; Zhaohui Zhong; Lei Zhang; Xuan Zhu; Shuiqing Wu; Kai Ai Journal: Sci Rep Date: 2016-07-07 Impact factor: 4.379
Authors: Christine Bekos; Matthias Zimmermann; Lukas Unger; Stefan Janik; Philipp Hacker; Andreas Mitterbauer; Michael Koller; Robert Fritz; Christian Gäbler; Mario Kessler; Stefanie Nickl; Jessica Didcock; Patrick Altmann; Thomas Haider; Georg Roth; Walter Klepetko; Hendrik Jan Ankersmit; Bernhard Moser Journal: Sci Rep Date: 2016-09-22 Impact factor: 4.379