Nonalbumin Proteinuria in Islet Transplant Recipients

Abstract

The aim of this study was to evaluate the importance of nonalbumin-predominant proteinuria on kidney function (KF) after islet transplantation (ITx). Twenty-four-hour proteinuria and albuminuria were available in 27 recipients. KF was assessed by serum creatinine and estimated glomerular filtration rate (eGFR) was calculated by Modification of Diet in Renal Disease formula. Correlations between eGFR and albuminuria (r = -0.422, p < 0.001) were higher than with proteinuria (r = -0.223, p < 0.001; p = 0.006 for comparison between correlations). Nineteen (70%) subjects had proteinuria >or= 300 mg/24 h during the follow-up. Subjects were divided into three groups according to urinary protein excretion patterns: no proteinuria (n = 8), nonalbumin-predominant (n = 8), and albumin-predominant (n = 11) proteinuria. Proteinuria >or= 500 mg/24 h was observed only among patients with albumin-predominant proteinuria (64%; p = 0.002) and these patients had the lowest eGFR means post-ITx (no proteinuria: 84.2 +/- 16.4 vs. nonalbumin: 69.1 +/- 13.8 vs. albumin-predominant proteinuria: 65.5 +/- 16.6 ml/min/1.73 m(2), p = 0.044 for first vs. last group). In conclusion, high frequency of proteinuria was observed after ITx. However, it seems to be milder and have less impact on KF when albumin is not the major source of proteinuria. Prospective evaluation of proteinuria, including tubular function markers, should be performed to elucidate the mechanisms of kidney damage in this population.

Islet Transplantation in Type 1 Diabetes: Ongoing Challenges, Refined Procedures, and Long-Term Outcome

“…While high rates of one-year insulin independence were observed in Edmonton and other leading islet centers [197], it became apparent that high-dose sirolimus was difficult to titrate when extended to an international multicenter trial [198][199][200]. High rates of mouth ulceration [100,101], ovarian cysts [201][202][203], fatigue, diarrhea, occasional severe small bowel ulceration [204], pneumonitis [205], edema [108,206], and proteinuria [207,208] have made this approach less attractive. We have largely abandoned the use of sirolimus at the University of Alberta for islet transplantation, finding that higherdose tacrolimus and MMF are far better tolerated [121].…”

Shotgun Proteomics and Network Analysis between Plasma Membrane and Extracellular Matrix Proteins from Rat Olfactory Ensheathing Cells

“…In the mammalian adult central nervous system (CNS), recovery from injury is generally poor, and spontaneous nerve regeneration occurs only in restricted regions of the CNS. The damage to nerve fiber pathways results in a devastating loss of function, due to the disconnection of nerve fibers from their targets (22,34,59). An exception to this rule is found in the olfactory system, in which olfactory receptor neurons (ORNs) undergo natural and injury-induced turnover and functional neurogenesis throughout life (25).…”

“…The damage to nerve fiber pathways ment of the olfactory system elsewhere (12,21). Ao et al 's research shows that the effectiveness of OECs inresults in a devastating loss of function, due to the disconnection of nerve fibers from their targets (22,34,59).…”

“…The damage to nerve fiber pathways ment of the olfactory system elsewhere (12,21). Ao et al's research shows that the effectiveness of OECs inresults in a devastating loss of function, due to the disconnection of nerve fibers from their targets (22,34,59). duced neural differentiation of neural stem cells (NSCs) and their culture medium concentrations of total protein An exception to this rule is found in the olfactory system, in which olfactory receptor neurons (ORNs) unsecretion was positively correlated.…”