Urine Protein Analysis Can Detect Kidney Rejection in Transplant Patients
More than 50% of kidney transplants fail over time. This is obviously a very high number, and kidney failure can be life threatening. Currently, the only method that is available to predict whether the transplanted kidney is being rejected or not is to get a very invasive kidney biopsy. There are generally two ways of kidney rejection: interstitial fibrosis/tubular atrophy & chronic antibody-mediated rejection. While both of these conditions will lead to kidney dysfunction, they have very different outcomes. It is important to identify which type of rejection it is, so that doctors can accurately treat the patient with the correct immunosuppressive therapy.
A new study indicates that the analysis of the urine can be critical to understanding which type of failure is occurring. In this study, the researchers were able to correctly predict which type of rejection was occurring 100% of the time. While this study only included fifty people, the results are very impressive. The researchers would analyze the protein in the urine and were able to determine which rejection it was based on the type of protein that they found in that urine. There should be no protein in the urine in a healthy individual, so that is the first clue that there is kidney rejection. However, without knowing which type of rejection it is, it is very difficult to treat the patient appropriately.
I found this article interesting because it made a lot of sense to me. When the blood gets filtered at the glomerulus, it has three barriers that it needs to cross: the capillary endothelium, a basal lamina, and the epithelium of Bowman’s capsule. Under normal circumstances, proteins will not even be able to penetrate the first barrier, the capillary endothelium. While this endothelium is fenestrated, it is not large enough to let proteins through. The next two barriers are even smaller. Perhaps the difference in the proteins that the researchers are finding in the urine is their size. The different types of rejections will destroy these three barriers to a different degree, allowing different sizes of proteins to pass through. The researchers can identify these proteins and noninvasively diagnose the mode of rejection. While this study is very promising, a more wide scaled study needs to be performed to confirm these results.
http://www.sciencedaily.com/releases/2008/11/081126215256.htm
A new study indicates that the analysis of the urine can be critical to understanding which type of failure is occurring. In this study, the researchers were able to correctly predict which type of rejection was occurring 100% of the time. While this study only included fifty people, the results are very impressive. The researchers would analyze the protein in the urine and were able to determine which rejection it was based on the type of protein that they found in that urine. There should be no protein in the urine in a healthy individual, so that is the first clue that there is kidney rejection. However, without knowing which type of rejection it is, it is very difficult to treat the patient appropriately.
I found this article interesting because it made a lot of sense to me. When the blood gets filtered at the glomerulus, it has three barriers that it needs to cross: the capillary endothelium, a basal lamina, and the epithelium of Bowman’s capsule. Under normal circumstances, proteins will not even be able to penetrate the first barrier, the capillary endothelium. While this endothelium is fenestrated, it is not large enough to let proteins through. The next two barriers are even smaller. Perhaps the difference in the proteins that the researchers are finding in the urine is their size. The different types of rejections will destroy these three barriers to a different degree, allowing different sizes of proteins to pass through. The researchers can identify these proteins and noninvasively diagnose the mode of rejection. While this study is very promising, a more wide scaled study needs to be performed to confirm these results.
http://www.sciencedaily.com/releases/2008/11/081126215256.htm
posted by Richard Hendrick at 8:43 AM
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