ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: SA-PO918

Urinary Extracellular Vesicle Analysis Reveals Early Signs of Kidney Inflammation and Damage in Single-Ventricle Pediatric Patients after Fontan Operation

Session Information

Category: Pathology and Lab Medicine

  • 1800 Pathology and Lab Medicine

Authors

  • Grange, Cristina, Universita degli Studi di Torino, Torino, Piemonte, Italy
  • Prudente, Diego, Universita degli Studi di Torino, Torino, Piemonte, Italy
  • Bussolati, Benedetta, Universita degli Studi di Torino, Torino, Piemonte, Italy
Background

Extracellular vesicles present in urine (uEVs) are gaining considerable interest as biomarkers, to monitor and predict kidney physio-pathological state. Patients with single ventricle defects and hemodynamic stabilization by Fontan intervention may develop kidney dysfunction as one of the most prevalent extracardiac co-morbidity. Our study aimed to identify markers for monitoring and predicting kidney function in children with single ventricle heart defects who underwent Fontan surgery, as well to get physio-pathological insights on possible mechanisms of tissue damage and progression.

Methods

We isolated uEVs from urine of 60 paediatric patients affected by single ventricle defects, and from 10 healthy subjects. We analysed uEVs for the expression of the reno-protective hormone Klotho, using super- resolution microscopy of single EVs and ELISA. Moreover, we analysed the level of marker of kidney regeneration, such as CD133 and CD24, and of inflammation using a bead-based cytofluorimetric multiplex analysis. Marker expression was correlated with demographical, clinical and surgical data of patients.

Results

uEVs from children with single ventricle defects showed reduced levels of Klotho and CD133, compared with the one of healthy subject. In parallel, the levels of inflammatory markers (CD3, CD56, and HLA-DR) were significantly higher. Interestingly, levels of inflammatory markers correlated with age of patients and distance from surgery.

Conclusion

This study demonstrates that EVs isolated from the urine of single ventricle patients. present distinct expression of biomarkers of fibrosis, regeneration and inflammation in respect to those of healthy subjects, suggesting the presence of early signs of kidney damage.

Experimental scheme