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The urine urokinase concentration in end stage renal disease with acquired renal cyst
1Department of Internal Medicine, Soonchuhyang University Hospital, Chunan, Korea.
Insights
Urine urokinase levels are significantly higher in patients with acquired cystic kidney disease (ACKD) and end-stage renal disease (ESRD) compared to controls. Longer dialysis duration correlates with increased urokinase concentration in both ACKD and control groups.
Area of Science:
- Nephrology
- Urology
- Biochemistry
Background:
- Acquired cystic kidney disease (ACKD) is a common complication in patients with end-stage renal disease (ESRD).
- The pathogenesis of ACKD and its relationship with urinary factors remain incompletely understood.
- Urokinase, a serine protease, has been implicated in various kidney diseases.
Purpose of the Study:
- To investigate the urine urokinase concentration in patients with ACKD compared to control groups undergoing chronic hemodialysis.
- To explore the correlation between urine urokinase levels, dialysis duration, and the presence of cystic kidney disease in ESRD patients.
Main Methods:
- A cohort of fifty end-stage renal disease (ESRD) patients on chronic hemodialysis was evaluated.
- Urine urokinase concentration was measured and compared between patients with acquired cystic kidney disease (ACKD), polycystic kidney disease, and a control group (non-cystic kidneys).
- Statistical analysis was performed to determine significant differences and correlations.
Main Results:
- Urine urokinase concentration was significantly higher in the ACKD group (17.5 unit/ml) than in the control group (4.1 unit/ml) and the polycystic kidney disease group (2.6 unit/ml).
- No significant difference in urine urokinase was observed between the control and polycystic kidney disease groups.
- A direct positive correlation was found between the duration of hemodialysis and urine urokinase concentration in both control and ACKD groups (r² = 0.424, p = 0.0001).
- Hemodialysis duration was significantly longer in the ACKD group (42 months) compared to the control group (20 months).
Conclusions:
- Elevated urine urokinase levels in ACKD patients suggest a potential role in cystogenesis.
- The duration of hemodialysis may influence urokinase production and contribute to ACKD development.
- Urokinase is a potential factor involved in the cystogenic degeneration observed in end-stage renal disease.
Abstract:
To see whether there was any difference in the urine urokinase concentration between acquired cystic kidney disease (ACKD) group and control (non cyst) group in end stage renal disease patients (ESRD), we evaluated fifty ESRD patients who had been maintained on chronic hemodialysis for various period. The urine urokinase concentration was higher in the ACKD group (17.5 +/- 14.7 unit/ml, range 13.5-47.0 unit/ml, n = 9) than the control group (4.1 +/- 3.4 unit/ml, range 0.5-12.0 unit/ml, n = 36) (p less than 0.001), and polycyst group (2.6 +/- 1.8 unit/ml, range 1.0-5.1 unit/ml, n = 5) (p less than 0.01). But there was no difference between the control group and polycyst group. In the control group and the ACKD group, there was a direct relation between the dialysis duration and the urokinase concentration and the longer the dialysis duration, the higher the urine urokinase concentration (r squared = 0.424, p = 0.0001). The hemodialysis duration was longer in the ACKD group (42 +/- 17.0 months) than the control group (20.0 +/- 12.5 months) (p less than 0.005). These findings suggest that urokinase may be responsible for cystogenic degeneration in ESRD.