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Apelin is expressed throughout the human kidney, is elevated in chronic kidney disease & associates independently

Duuamene Nyimanu1, Fiona A Chapman2,3, Peter J Gallacher2

  • 1Division of Experimental Medicine and Immunotherapeutics, University of Cambridge, Cambridge, UK.

British Journal of Clinical Pharmacology
|June 24, 2022
PubMed

Insights

Plasma apelin is elevated in chronic kidney disease (CKD) and may indicate a higher risk of kidney function decline. The apelin system is present in healthy kidneys, warranting further research into apelin agonism as a CKD therapy.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Endocrinology

Background:

  • Cardiovascular disease (CVD) is a major complication of chronic kidney disease (CKD).
  • The apelin system presents a potential therapeutic target for CVD, but its role in CKD remains under-explored.
  • Limited data exist on the expression and function of the apelin system in the context of CKD.

Purpose of the Study:

  • To investigate the expression of the apelin system in healthy human kidneys.
  • To examine the levels of apelin and Elabela/Toddler (ELA) in patients with CKD.
  • To explore the association between apelin, ELA, and cardiovascular health in CKD patients.

Main Methods:

  • Autoradiography, immunohistochemistry, and ELISA were used to assess apelin system expression in kidney tissue.
  • Plasma levels of apelin and ELA were measured in 128 CKD patients and 27 healthy controls.
  • Cardiovascular parameters including blood pressure, arterial stiffness, and endothelial function were assessed over a 5-year follow-up period.

Main Results:

  • The apelin system is expressed throughout the nephron in healthy human kidneys.
  • Plasma apelin concentrations were significantly higher in women than men and increased with declining glomerular filtration rate and rising albuminuria in CKD patients.
  • Elevated plasma apelin and ELA were associated with vascular dysfunction, and plasma apelin independently predicted a 50% decline in glomerular filtration rate over 5 years.

Conclusions:

  • This study demonstrates the expression of the apelin system in healthy human kidneys.
  • Elevated plasma apelin levels in CKD patients may serve as a potential biomarker for the risk of kidney function decline.
  • Further clinical investigations into the therapeutic potential of apelin agonism for CKD are warranted.
Abstract

Keywords:
apelincardiovascular systemchronic kidney disease

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