Fractional excretion of tumor necrosis factor receptor 1 and 2 in patients with type 2 diabetes and normal renal function

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  • Tomohito Gohda
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Nozomu Kamei
    Department of Endocrinology and Metabolism Hiroshima Red Cross Hospital and Atomic‐bomb Survivors Hospital Hiroshima Japan
  • Mitsunobu Kubota
    Department of Endocrinology and Diabetology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Hiroshima Japan
  • Kanako Tanaka
    Department of Endocrinology and Diabetology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Hiroshima Japan
  • Yoshinori Yamashita
    Institute for Clinical Research National Hospital Organization Kure Medical Center and Chugoku Cancer Center Hiroshima Japan
  • Hiroko Sakuma
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Chiaki Kishida
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Eri Adachi
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Takeo Koshida
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Maki Murakoshi
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Shinji Hagiwara
    Department of Kidney and hypertension Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan
  • Kazuhiko Funabiki
    Department of Kidney and hypertension Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan
  • Seiji Ueda
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan
  • Yusuke Suzuki
    Department of Nephrology Faculty of Medicine Juntendo University Tokyo Japan

書誌事項

公開日
2020-08-10
資源種別
journal article
権利情報
  • http://creativecommons.org/licenses/by-nc/4.0/
DOI
  • 10.1111/jdi.13351
公開者
Wiley

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説明

<jats:title>Abstract</jats:title><jats:sec><jats:title>Aims/Introduction</jats:title><jats:p>Increased concentrations of serum tumor necrosis factor (TNF) receptors (TNFRs; TNFR1 and TNFR2) are positively associated with the urinary albumin‐to‐creatinine ratio (ACR), and negatively associated with the estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes. However, the mechanism underlying this increase and the relationship between TNFRs in serum, and urine and kidney measures (ACR and eGFR) are unclear.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>This was a cross‐sectional study that included 499 patients with type 2 diabetes and eGFR ≥60 mL/min/1.73 m<jats:sup>2</jats:sup>. The concentrations of TNFRs in serum and urine, and their respective fractional excretion, were measured.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Serum and urinary TNFR levels were positively associated with the ACR, and negatively associated with the eGFR. The fractional excretion of TNFRs did not differ between patients with an eGFR ≥90 and those with an eGFR 60–89 mL/min/1.73 m<jats:sup>2</jats:sup>, and also did not correlate with eGFR. After adjustment for relevant covariates, the serum TNFRs were associated with a lower eGFR (60–89 mL/min/1.73 m<jats:sup>2</jats:sup>) and an increased ACR (≥30 mg/gCr), but urinary TNFRs were associated with an increased ACR (≥30 mg/gCr) alone, in the multivariate logistic model.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The pattern of fractional excretion TNFRs showed that an increase in serum TNFRs might result from their increased systemic production, including in the kidney, rather than being a simple reflection of GFR decline. Kidney measures appear to be strongly associated with serum TNFRs rather than urinary TNFRs in patients with type 2 diabetes and normal renal function.</jats:p></jats:sec>

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