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Abstract: SA-PO923

Detection of Chronic Glomerular Nephritis in Nephrotic Patients Using D-amino Acids

Session Information

Category: Pathology and Lab Medicine

  • 1800 Pathology and Lab Medicine

Authors

  • Kimura, Tomonori, Osaka Daigaku, Suita, Osaka, Japan
  • Sakai, Shinsuke, Osaka Daigaku, Suita, Osaka, Japan
  • Iwata, Yukimasa, Sakai Shiritsu Sogo Iryo Center, Sakai, Osaka, Japan
  • Okushima, Hiroki, Osaka Daigaku, Suita, Osaka, Japan
  • Hayashi, Terumasa, Osaka Kyuseiki Sogo Iryo Center, Osaka, Osaka, Japan
  • Mizui, Masayuki, Osaka Daigaku, Suita, Osaka, Japan
  • Isaka, Yoshitaka, Osaka Daigaku, Suita, Osaka, Japan
Background

Patients with chronic glomerular nephritis (CGN) is often complicated with diabetes, and it is often a diagnostic challenge to detect CGN in patients with diabetes. D-amino acids, rare enantiomers of amino acids, are kidney biomarkers that are useful to assess glomerular filtration rate and prognosis of kidney disease. Furthermore, combinational assessment of D-serine, one of D-amino acids, in blood and urine has the diagnostic potential to identify the origin of kidney diseases. We aimed to differentiate diabetic nephropathy from chronic glomerular nephritis in patients with higher level of urinary proteins by broadening the range of D-amino acid measurements.

Methods

Patients with biopsy-proven diabetic nephropathy, minimal change disease, and IgA nephropathy, and participants without kidney disease, were analyzed. The levels of four major D-amino acids in blood and urine were measured using two-dimensional high-performance liquid chromatography. Multivariate analysis was performed to identify the ideal marker for the diagnosis of CGN from diabetic nephropathy (DN).

Results

A total of 566 patients were analyzed. Multivariate analysis identified that the parameters calculated from the combination of D-amino acids have the diagnostic value to differentiate CGN from DN. ROC curve analysis showed that area under the curve of 0.833 for the differentiation of CGN from DN in patients with the nephrotic range of urinary protein.

Conclusion

Combinational analysis of D-amino acids in blood and urinary excretion is useful in the differentiation of CGN from DN. Profiling of D-amino acids may help the diagnosis of origin of kidney disease in nephrotic patients.