Dai X.b· Liu F.c· Zhang L.a· Duan L.a· Huang Y.a· Qian S.a

Author affiliations

aDepartment of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
bDepartment of Urology, Shanghai East Hospital, Dalian Medical University, Shanghai, China
cDepartment of Urology, Changxing People’s Hospital of Chongming District, Shanghai, China

Log in to MyKarger to check if you already have access to this content.

Buy FullText & PDF Unlimited re-access via MyKarger Unrestricted printing, no saving restrictions for personal use read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Access via DeepDyve Unlimited fulltext viewing Of this article Organize, annotate And mark up articles Printing And downloading restrictions apply

Select

Subscribe Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use read more

Subcription rates

Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview

Received: February 24, 2022
Accepted: June 22, 2022
Published online: August 09, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Abstract

Introduction: This study was conducted to investigate the underlying associations between urine macrophages polarization and renal function recovery after nephron-sparing surgery (NSS) in patients with renal cell carcinoma (RCC) and to explore the potential application values of urine macrophages polarization in predicting the severity of renal ischemia/reperfusion injury (RIRI). Methods: Sixty-two patients with unilateral RCC who underwent NSS in our departments were prospectively recorded and followed up for long-term renal function to assess the onset of acute kidney injury (AKI) and chronic kidney disease (CKD). Urine samples of patients were collected 72 h after surgery for analyzing pro-inflammatory (classically activated/M1) and pro-reparative (alternatively activated/M2) macrophages polarization by flow cytometry. The detailed correlations between urine macrophages polarization and renal function recovery after NSS were explored by statistical analyses. Results: The cumulative incidence of postoperative AKI was 27.4% (17/62), and 47.0% (8/17) of those eventually developed to CKD during the follow-up. The mean urine M1/M2 ratio was 10.54 ± 8.13 in the AKI group and 3.93 ± 3.10 in the non-AKI group, presenting a significant statistical difference (p < 0.0001). Meanwhile, the urine M1/M2 ratio presented amazing potential in predicting postoperative CKD as well, with a mean ratio of 12.54 ± 9.41 in the CKD group and 4.28 ± 3.21 in the non-CKD group (p < 0.0001). Though univariate analysis implied that urine M1/M2 ratio was a relevant factor of both postoperative AKI and CKD in NSS surgical patients, multivariate analysis did not show satisfying predicting potential in postoperative CKD, mainly due to the very limited candidates enrolled in this study. Conclusion: Urine macrophages polarization could predict renal function recovery after NSS in patients with RCC. The urine M1/M2 ratio might a potential biomarker of RIRI but needs to be further verified in clinical settings.

© 2022 S. Karger AG, Basel

References Ebbing J, Menzel F, Frumento P, Miller K, Ralla B, Fuller TF, et al. Correction to: outcome of kidney function after ischaemic and zero-ischaemic laparoscopic and open nephron-sparing surgery for renal cell cancer. BMC Nephrol. 2019;20(1):86. Muramaki M, Miyake H, Sakai I, Fujisawa M. Prognostic factors influencing postoperative development of chronic kidney disease in patients with small renal tumors who underwent partial nephrectomy. Curr Urol. 2013;6(3):129–35. Malcolm JB, Bagrodia A, Derweesh IH, Mehrazin R, Diblasio CJ, Wake RW, et al. Comparison of rates and risk factors for developing chronic renal insufficiency, proteinuria and metabolic acidosis after radical or partial nephrectomy. BJU Int. 2009;104(4):476–81. Godoy G, Ramanathan V, Kanofsky JA, O'Malley RL, Tareen BU, Taneja SS, et al. Effect of warm ischemia time during laparoscopic partial nephrectomy on early postoperative glomerular filtration rate. J Urol. 2009;181(6):2438–45; discussion 43–5 Sorbellini M, Kattan MW, Snyder ME, Hakimi AA, Sarasohn DM, Russo P, et al. Prognostic nomogram for renal insufficiency after radical or partial nephrectomy. J Urol. 2006;176(2):472–6; discussion 476 Shikanov S, Lifshitz D, Chan AA, Okhunov Z, Ordonez MA, Wheat JC, et al. Impact of ischemia on renal function after laparoscopic partial nephrectomy: a multicenter study. J Urol. 2010;183(5):1714–8. Jeon HG, Jeong IG, Lee JW, Lee SE, Lee E. Prognostic factors for chronic kidney disease after curative surgery in patients with small renal tumors. Urology. 2009;74(5):1064–8. Song C, Bang JK, Park HK, Ahn H. Factors influencing renal function reduction after partial nephrectomy. J Urol. 2009;181(1):48–53; discussion 53–4 Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7(9):735–40. Thakar CV, Christianson A, Himmelfarb J, Leonard AC. Acute kidney injury episodes and chronic kidney disease risk in diabetes mellitus. Clin J Am Soc Nephrol. 2011;6(11):2567–72. Adeyemi OA, Flaherty JP. Emphysematous cystitis. Emphysematous Cystitis Cureus. 2020;12(11):e11723. Cao Q, Harris DCH, Wang Y. Macrophages in kidney injury, inflammation, and fibrosis. Physiology. 2015;30(3):183–94. Sun PP, Zhou XJ, Su JQ, Wang C, Yu XJ, Su T, et al. Urine macrophages reflect kidney macrophage content during acute tubular interstitial and glomerular injury. Clin Immunol. 2019;205:65–74. Cho WY, Choi HM, Lee SY, Kim MG, Kim HK, Jo SK, et al. The role of Tregs and CD11c(+) macrophages/dendritic cells in ischemic preconditioning of the kidney. Kidney Int. 2010;78(10):981–92. Jo SK, Sung SA, Cho WY, Go KJ, Kim HK. Macrophages contribute to the initiation of ischaemic acute renal failure in rats. Nephrol Dial Transpl. 2006;21(5):1231–9. Lee S, Huen S, Nishio H, Nishio S, Lee HK, Choi BS, et al. Distinct macrophage phenotypes contribute to kidney injury and repair. J Am Soc Nephrol. 2011;22(2):317–26. Park SW, Jung SG, Lee W, Chung MK. Changes in renal function after nephron-sparing surgery in patients with a normal contralateral kidney. Int J Urol. 2010;17(5):457–61. Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179–84. Rocco MV, Gassman JJ, Wang SR, Kaplan RM. Cross-sectional study of quality of life and symptoms in chronic renal disease patients: the modification of diet in renal disease study. Am J Kidney Dis. 1997;29(6):888–96. Bonventre JV, Yang L. Cellular pathophysiology of ischemic acute kidney injury. J Clin Invest. 2011;121(11):4210–21. Sharfuddin AA, Molitoris BA. Pathophysiology of ischemic acute kidney injury. Nat Rev Nephrol. 2011;7(4):189–200. Venkatachalam MA, Griffin KA, Lan R, Geng H, Saikumar P, Bidani AK, et al. Acute kidney injury: a springboard for progression in chronic kidney disease. Am J Physiol Ren Physiol. 2010;298(5):F1078–94. Venkatachalam MA, Weinberg JM, Kriz W, Bidani AK. Failed tubule recovery, AKI-CKD transition, and kidney disease progression. J Am Soc Nephrol. 2015;26(8):1765–76. Huen SC, Cantley LG. Macrophage-mediated injury and repair after ischemic kidney injury. Pediatr Nephrol. 2015;30(2):199–209. Ye L, He S, Mao X, Zhang Y, Cai Y, Li S, et al. Effect of hepatic macrophage polarization and apoptosis on liver ischemia and reperfusion injury during liver transplantation. Front Immunol. 2020;11:1193. Dai Y, Wang S, Chang S, Ren D, Shali S, Li C, et al. M2 macrophage-derived exosomes carry microRNA-148a to alleviate myocardial ischemia/reperfusion injury via inhibiting TXNIP and the TLR4/NF-κB/NLRP3 inflammasome signaling pathway. J Mol Cell Cardiol. 2020;142:65–79. Hu X, Xu Y, Zhang Z, Tang Z, Zhang J, Luo Y, et al. TSC1 affects the process of renal ischemia-reperfusion injury by controlling macrophage polarization. Front Immunol. 2021;12:637335. Huen SC, Huynh L, Marlier A, Lee Y, Moeckel GW, Cantley LG, et al. GM-CSF promotes macrophage alternative activation after renal ischemia/reperfusion injury. J Am Soc Nephrol. 2015;26(6):1334–45. Yang L, Brooks CR, Xiao S, Sabbisetti V, Yeung MY, Hsiao LL, et al. KIM-1-mediated phagocytosis reduces acute injury to the kidney. J Clin Invest. 2015;125(4):1620–36. Article / Publication Details

First-Page Preview

Received: February 24, 2022
Accepted: June 22, 2022
Published online: August 09, 2022

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 2

ISSN: 0042-1138 (Print)
eISSN: 1423-0399 (Online)

For additional information: https://www.karger.com/UIN

Copyright / Drug Dosage / Disclaimer Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.