Relationship Between the Brain Natriuretic Peptide (BNP) Level and Prognosis of Diabetic Nephropathy with Microalbuminuria: A 7-Year Follow-Up Study

Seki, Norio; Matsumoto, Tsuyoshi; Fukazawa, Motoharu

doi:10.1055/a-0603-3792

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…Another study found that injection of BNP, which is mainly activated by furin [15,16,27], can lead to glomerular hyperfiltration in mice [28]. The association between BNP and microalbuminuria has also been observed in populations [9,29]. The underlined mechanisms need to be discussed to deepen our understanding of the role of furin in microalbuminuria.…”

Section: Discussionmentioning

confidence: 99%

“…In-depth understanding of the mechanisms and risk factors of microalbuminuria is undoubted of great relevance for the prevention and management of this debilitating disorder and related complications, e.g., kidney and vascular diseases. Natriuretic peptide system has been involved in the pathogenesis of microalbuminuria [7][8][9][10] through shedding the endothelial glycocalyx [11,12], increasing vascular permeability [12], enhancing hydraulic pressure in the glomerular capillaries [13,14], and thereby resulting in increased excretion of albumin in the urine. As a key activator of the precursor of brain natriuretic peptide (BNP), one key component of natriuretic peptide system, furin may play a critical role in the natriuretic peptide system and thus participates in the pathogenesis of microalbuminuria [15,16].…”

Section: Introductionmentioning

confidence: 99%

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A higher level of serum furin indicates a higher risk of microalbuminuria: results from a longitudinal study in Chinese adults

Ren

Chen

Zhang³

et al. 2020

Clin Exp Nephrol

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Background Furin, a key enzyme of natriuretic peptide system, has been suggested to play a role in microalbuminuria, but the association between furin and microalbuminuria has been scarcely studied. Methods Leveraging a longitudinal cohort of Chinese adults who had urinary albumin measured twice 4 years apart, we examined the cross-sectional and prospective associations of baseline serum furin with microalbuminuria, adjusting for age, sex, education level, smoking, drinking, obesity, blood pressure, glucose, lipids, and antihypertensive medications. Results The cross-sectional analysis in 2175 participants (53 ± 10 years, 38% men) found that a 10-time higher level of serum furin was significantly associated with a 64% higher risk of having microalbuminuria (OR = 1.64, P = 0.005). The longitudinal analysis found a positive association between baseline serum furin and dynamic elevation of albumin excretion during follow-up. The prospective analysis in 1357 participants free of microalbuminuria at baseline found that a 10-time higher level of serum furin at baseline was significantly associated with a 1.28-time higher risk of developing microalbuminuria 4 years later (OR = 2.28, P < 0.001). Conclusions A higher level of serum furin at baseline predicted an increased risk of developing microalbuminuria in Chinese adults. These findings indicate that furin might be a predictor or a risk factor for microalbuminuria but the causality still needs more investigations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A higher level of serum furin indicates a higher risk of microalbuminuria: results from a longitudinal study in Chinese adults

Ren

Chen

Zhang³

et al. 2020

Clin Exp Nephrol

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“…Previous studies [ 22 , 23 ] found a positive correlation between NT-proBNP concentrations and the severity of proteinuria in patients with T2DM. Other studies [ 24 , 25 ] showed that NT-proBNP concentrations were negatively correlated with baseline eGFR and positively correlated with kidney function decline in patients with CKD.…”

Section: Discussionmentioning

confidence: 88%

The association of plasma NT-proBNP level and progression of diabetic kidney disease

Zhao

Wang

et al. 2023

Renal Failure

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Aims Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease (ESKD). The identification of risk factors involved in the progression of DKD to ESKD is expected to result in early detection and appropriate intervention and improve prognosis. This study aimed to explore whether plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) was associated with kidney outcomes in patients with type 2 diabetes mellitus (T2DM) and biopsy-proven DKD. Methods Patients with biopsy-proven DKD who were followed up at West China Hospital over 12 months were enrolled. The kidney outcome was defined as progression to ESKD. The cutoff value of plasma NT-proBNP concentration was calculated by using receiver operating characteristic (ROC) curve analysis. The influence of NT-proBNP levels on kidney outcome in patients with DKD was assessed using Cox regression analysis. Results A total of 30 (24.5%) patients reached ESKD during a median follow-up of 24.1 months. The baseline serum NT-proBNP level had a significant correlation with baseline proteinuria, kidney function, glomerular lesions, interstitial fibrosis tubular atrophy (IFTA), and arteriolar hyalinosis. Multivariate Cox regression analysis indicated that increased NT-proBNP level was significantly associated with a higher risk of progression to ESKD (HR 6.43; 95% CI (1.65–25.10, p = 0.007), and each 1 SD increase in LG (NT-proBNP) was also associated with a higher risk (HR 2.43; 95% CI 1.94–5.29, p = 0.047) of an adverse kidney outcome after adjusting for confounding factors. Conclusions A higher level of plasma NT-proBNP predicts kidney prognosis in patients with biopsy-proven DKD. This warrants further investigation into the potential mechanisms.

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“…Previous studies have shown that DN cannot be effectively suppressed even if blood sugar and blood pressure are strictly controlled in diabetic patients. Indeed, about 33 % of diabetic patients still end up with end-stage renal disease [8]. Therefore, early diagnosis of diabetes and early treatment are of great significance for delaying the development of DN and improving life quality amongst diabetics.…”

Section: Discussionmentioning

confidence: 99%

Effect of dexmedetomidine on AKT/ERK signaling pathway and EMT-related proteins in high glucose-induced apoptosis in human renal tubular epithelial cells

Wei¹,

Wu²,

Liu³

et al. 2022

Trop. J. Pharm Res

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Purpose: To study the effect of dexmedetomidine (Dex) on AKTERK signaling pathway and EMT- related proteins in high glucose-induced apoptosis in human kidney tubular epithelial cells. Methods: HK-2 cells were assigned to control, high-glucose and Dex groups. Levels of ROS were determined using live cell station. Flow cytometry was used to measure cell apoptosis and cell cycle while Western blot was applied to assay levels of PI3K, Akt, p-Akt, ERK and p-ERK. Results: The ROS concentrations were markedly reduced in Dex group, relative to high glucose group (p < 0.05). Apoptosis was reduced in Dex group, relative to high glucose group, while P13K protein levels were significantly lower in high glucose and Dex groups than their corresponding control levels. In the high glucose-treated cells, AKT protein expression was downregulated, relative to control group, and p-AKT expression was markedly reduced in Dex group (p < 0.05). Protein expressions of ERK and p-ERK in high glucose group were lower than control values, but were significantly accentuated in Dex group, relative to high glucose group (p < 0.05). Conclusion: Dex mitigates high glucose-induced apoptosis of HK-2 cells, increases the proportion of cells in G1 phase, and reduces their EMT via a mechanism related to regulation of AKTERK signaling pathway-associated proteins. AKTERK signaling pathway-associated proteins provide insights into the development of drugs for the treatment of diabetic nephropathy.

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Relationship Between the Brain Natriuretic Peptide (BNP) Level and Prognosis of Diabetic Nephropathy with Microalbuminuria: A 7-Year Follow-Up Study

Cited by 8 publications

References 36 publications

A higher level of serum furin indicates a higher risk of microalbuminuria: results from a longitudinal study in Chinese adults

A higher level of serum furin indicates a higher risk of microalbuminuria: results from a longitudinal study in Chinese adults

The association of plasma NT-proBNP level and progression of diabetic kidney disease

Effect of dexmedetomidine on AKT/ERK signaling pathway and EMT-related proteins in high glucose-induced apoptosis in human renal tubular epithelial cells

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