A Novel Biomarker for Acute Kidney Injury, Vanin-1, for Obstructive Nephropathy: A Prospective Cohort Pilot Study

Abstract

Background: Vanin-1 is a novel acute kidney injury (AKI) biomarker that has not been clinically investigated as a biomarker for obstructive nephropathy. This study investigated the diagnostic value of vanin-1 as a biomarker for adult obstructive nephropathy by comparing it to existing AKI biomarkers. Methods: A total of 49 patients, 21 controls, and 28 hydronephrosis (HN) cases were assessed. AKI biomarkers in bladder (BL) urine and renal pelvic (RP) urine in the HN group were compared to each BL marker in the control group. In a subgroup of cases receiving interventions for obstructive nephropathy, the BL values of each biomarker were assessed after the intervention. Results: RP vanin-1 levels were significantly higher while BL vanin-1 levels were marginally higher in the HN group than in the control group. The area under the receiver operating characteristics curve values for RP and BL vanin-1 were 0.9778 and 0.6386, respectively. In multivariate analyses, BL vanin-1 and N-acetyl-β-D-glucosaminidase (NAG), but not kidney injury molecule-1 (KIM-1) or neutrophil gelatinase-associated lipocalin (NGAL), were independent factors for predicting the presence of HN. In cases receiving interventions, vanin-1 decreased significantly from 1 week after the intervention in cases of moderate to severe obstructive nephropathy compared to RP values at baseline. Conclusion: Urinary vanin-1 is a useful biomarker to detect and monitor the clinical course of obstructive nephropathy.

Urinary vanin‐1 and chronic kidney disease in hypertensive patients

“…Hosohata and colleagues previously suggested that urinary vanin‐1 is a potentially early biomarker for renal tubular damage in spontaneously hypertensive rats under a high salt intake 23 . They also found that urinary vanin‐1 may be a useful biomarker to detect and monitor the clinical course of obstructive nephropathy 24 . The most important fact to arise from these authors’ current work is that they demonstrated that elevated urinary vanin‐1 level was significantly associated with lower eGFR in hypertensive patients.…”

Roles Played by Biomarkers of Kidney Injury in Patients with Upper Urinary Tract Obstruction

“…Technetium 99m ( 99m Tc) mertiatide, 99m Tc diethylene triamine penta-acetic acid, or 99m Tc dimercaptosuccinic acid renal scans (with or without diuresis) are commonly used to evaluate the presence and severity of UUTO in patients with hydronephrosis. Patients are divided into those with no, partial, or complete obstruction and with or without renal function [ 21 , 22 , 23 ]. Urgent surgical relief of complete obstruction is essential, otherwise the kidney will rapidly become nonfunctional.…”

“…An ideal biomarker is assessed noninvasively in a simple manner, is highly sensitive and specific in terms of early detection, and exhibits a wide dynamic range and cutoff values, allowing for risk stratification. Diagnostic utility improves when pelvic urine samples (compared to bladder urine) are used [ 23 , 24 ]. However, the collection of renal pelvic urine is invasive, requiring the placement of an indwelling ureteral catheter via cystoscopy under X-ray guidance, and thus it is difficult to repeatedly collect renal pelvic urine.…”

“…The AUC-ROC value for UUTO in children is 0.61–0.90 for bladder urine NGAL [ 26 , 36 , 45 , 46 , 47 , 48 ]. In adults with UUTO, the urine NGAL level increases in those with obstructive nephropathy (AUC-ROCs of 0.70 for bladder urine and 0.76 for renal pelvic urine) and decreases after relief of the obstruction [ 23 , 50 , 51 ]. Serum NGAL levels are significantly higher than in controls [ 45 , 50 ].…”

The potential role of B5: A stitch in time and switch in cytokine

“…The vanin‐1 gene was one of nine genes found to be up‐regulated in the early phase of acute kidney injury (Yoshida et al, ). Vanin‐1, present at the brush borders where the first filtration occurs, has been potentially considered as a biomarker for nephrotoxicant‐induced renal injury (Hosohata, Ando, & Fujimura, ; Hosohata, Ando, Fujiwara, & Fujimura, ; Washino et al, ).…”