Association between serum albumin level and incidence of end-stage renal disease in patients with Immunoglobulin A nephropathy: A possible role of albumin as an antioxidant agent

Abstract

Serum albumin is the major intravascular antioxidant. Though oxidative stress plays an important role in the pathophysiology of Immunoglobulin A nephropathy (IgAN), the association between serum albumin and the progression of IgAN is not entirely understood. This retrospective cohort study of 1,352 participants with biopsy-proven IgAN determined the associations between serum albumin level and the incidence of end-stage renal disease (ESRD) using a Cox proportional hazards model. Patients were divided into three groups by tertiles of serum albumin level: Low, Middle, and High group (≤3.9 g/dL, 4.0–4.3 g/dL, ≥4.4 g/dL, respectively). During the median 5.1-year follow-up period, 152 patients (11.2%) developed ESRD. Participants in the Low group had a 1.88-fold increased risk for ESRD compared with those in the High group after adjustment for clinical parameters, including urinary protein excretion, and pathological parameters (Oxford classification). We also experimentally proved the antioxidant capacity of albumin on mesangial cells. The intracellular reactive oxygen species and mitochondrial injury, induced by hydrogen peroxide were significantly attenuated in albumin-pretreated mouse mesangial cells and human kidney cells compared with γ-globulin-pretreated cells. Low serum albumin level is an independent risk factor for ESRD in patients with IgAN. The mechanism could be explained by the antioxidant capacity of serum albumin.

Integrated bioinformatics analysis reveals novel hub genes closely associated with pathological mechanisms of immunoglobulin A nephropathy

“…Several hub genes were identified from the PPI network, and this result is consistent with previously described genes, including ALB (31), FOS (32) and TP53 (33). TP53/p53 is a known regulator of apoptosis and macro-autophagy/autophagy (39).…”

“…2B). Of note, among the top 10 hub genes, ALB (31), FOS (32) and TP53 (33) are known to be involved in the pathological process of IgAN. The top five hub genes were considered for subsequent KEGG pathway analysis to narrow down the analysis.…”

Metabolome modulatory effects of Kigelia africana (Lam.) Benth. fruit extracts on oxidative stress, hyperlipidaemic biomarkers in STZ-induced diabetic rats and antidiabetic effects in 3T3 L1 adipocytes

“…Normally, an assault to the body of diabetic patients causes a reduction in the concentrations of total protein and albumin alongside increase in total bilirubin concentration. [62] The results of this study agreed with the works of Iwasaki et al, [63] Gonz alez-Pacheco et al, [64] Zhang et al [65] and Zhu et al [66] The high concentration of bilirubin in diabetic group of experimental rats as found in our study shows that a damage to the liver leads to the release of bilirubin into the bloodstream causing the levels to increase with reduction in the level of albumin and total protein. The impact of K. africana will be to normalize the levels of these biochemical biomarkers.…”

The Role of Cystatin C and Albumin in the Differential Diagnosis of Primary Chronic Glomerulonephritis and Hypertension-Induced Renal Injury

“…Human serum albumin is composed of 17 disulfides and one free cysteine, which is the most abundant intravascular protein and is widely used for routine clinical examination [7,8]. Moreover, serum albumin is the major intravascular antioxidant, is associated with the incidence of end-stage renal disease [7,9] and is a strong prognostic indicator for many disease processes [10,11].…”