Tumor necrosis factor-alpha mediates the negative association between telomere length and kidney dysfunction

Area of Science:

• Nephrology
• Genetics
• Inflammology

Background:

• The link between peripheral blood leukocyte telomere length (LTL) and kidney dysfunction, especially in hypertensive patients, is not well understood.
• The roles of inflammation and oxidative stress in the LTL-kidney dysfunction relationship require clinical investigation.

Purpose of the Study:

• To examine the association between baseline LTL and the progression of albuminuria and/or rapid decline in renal function in Chinese patients.
• To investigate the potential mediating roles of inflammation and oxidative stress in the LTL-kidney dysfunction relationship.

Main Methods:

• A 7-year prospective study (2014-2021) involving 262 patients.
• Assessment of LTL, inflammation and oxidative markers, renal function, and urine protein levels.
• Logistic regression and simple mediation models were employed for data analysis.

Main Results:

• A decrease in baseline LTL was significantly correlated with an increased risk of rapid renal function decline and a composite endpoint of kidney dysfunction.
• Tumor necrosis factor-alpha (TNF-a) was found to partly mediate the relationship between LTL and rapid renal function decline (22.4% mediation).
• The inverse association between LTL and kidney dysfunction was more pronounced in patients with hypertension.

Conclusions:

• Baseline leukocyte telomere length is an independent predictor of kidney dysfunction.
• The association between LTL and kidney dysfunction is particularly significant in hypertensive individuals.
• Tumor necrosis factor-alpha partially mediates the negative impact of LTL on kidney function.