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Plasma concentrations of syndecan-1 are dependent on kidney function
Robert G Hahn1,2, Markus Zdolsek3, Joachim Zdolsek3
1Research Unit, Södertälje Hospital, Södertälje, Sweden.
Acta Anaesthesiologica Scandinavica
|February 17, 2021
Summary
Kidney function significantly impacts plasma levels of syndecan-1 and heparan sulfate. Changes in renal clearance, not just glycocalyx shedding, can cause substantial elevations in these markers after injury.
Area of Science:
- Biochemistry
- Renal Physiology
- Critical Care Medicine
Background:
- Elevated plasma syndecan-1 and heparan sulfate are often attributed to glycocalyx degradation following trauma, sepsis, or surgery.
- This study investigates the potential role of kidney function in these observed plasma elevations.
Purpose of the Study:
- To explore the influence of renal clearance on plasma concentrations of syndecan-1 and heparan sulfate.
- To determine if changes in kidney function alone can account for significant fluctuations in these biomarkers.
Main Methods:
- Measured plasma and urine concentrations of syndecan-1, heparan sulfate, and inflammatory biomarkers over 5 hours in 15 post-burn injury patients.
- Calculated renal clearances (CLR) for syndecan-1 and heparan sulfate.
- Used simulations to predict the impact of CLR on plasma concentrations.
Main Results:
- Renal clearance of syndecan-1 and heparan sulfate varied significantly (250-fold and 10-fold, respectively).
- Syndecan-1 CLR correlated positively with creatinine clearance and urine flow.
- Heparan sulfate CLR increased with interleukin-6 and urine flow.
- Simulations indicated that altered CLR could double plasma syndecan-1 or triple heparan sulfate levels within 24 hours, independent of shedding.
Conclusions:
- Renal elimination of syndecan-1 and heparan sulfate exhibits substantial variability.
- Altered kidney function, common post-injury, can independently cause significant, multi-fold changes in plasma syndecan-1 and heparan sulfate concentrations.
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