Urinary cell-free mitochondrial and nuclear deoxyribonucleic acid correlates with the prognosis of chronic kidney diseases

• Published in: BMC nephrology Vol. 20; no. 1; p. 391
• Main Authors: Chang, Chia-Chu, Chiu, Ping-Fang, Wu, Chia-Lin, Kuo, Cheng-Ling, Huang, Ching-Shan, Liu, Chin-San, Huang, Ching-Hui
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.10.2019; BioMed Central; BMC
• Subjects: Albumin; Analysis; Biological markers; Cell-free mitochondrial deoxyribonucleic acid; Cell-free nuclear deoxyribonucleic acid; Cf-mtDNA; Cf-nDNA; Chronic kidney failure; Development and progression; DNA; Genetic research; Intelligence gathering; Kidney diseases; Mitochondrial DNA; Neutrophil gelatinase-associated lipocalin; NGAL; Nucleic acids; Prognosis; Regression analysis; Taiwan; NGAL; Cell-free nuclear deoxyribonucleic acid; Chronic kidney disease; Cf-mtDNA; Neutrophil gelatinase-associated lipocalin; Cell-free mitochondrial deoxyribonucleic acid; Cf-nDNA
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-019-1549-x

Cell-free deoxyribonucleic acid DNA (cf-DNA) in urine is promising due to the advantage of urine as an easily obtained and non-invasive sample source over tissue and blood. In clinical practice, it is important to identify non-invasive biomarkers of chronic kidney disease (CKD) in monitoring and surveillance of disease progression. Information is limited, however, regarding the relationship between urine and plasma cf-DNA and the renal outcome in CKD patients. One hundred and thirty-one CKD patients were enrolled between January 2016 and September 2018. Baseline urine and plasma cell-free mitochondrial DNA (cf-mtDNA) and cell-free nuclear DNA (cf-nDNA) were isolated using quantitative real-time PCR. Estimated glomerular filtration rate (eGFR) measurement was performed at baseline and 6-month follow-up. Favorable renal outcome was defined as eGFR at 6 months minus baseline eGFR> = 0. Receiver operator characteristics (ROC) curve analysis was performed to assess different samples of cf-DNA to predict favorable renal outcomes at 6 months. A multivariate linear regression model was used to evaluate independent associations between possible predictors and different samples of cf-DNA. Patients with an advanced stage of CKD has significantly low plasma cf-nDNA and high plasma neutrophil gelatinase-associated lipocalin (NGAL) levels. Low urine cf-mtDNA, cf-nDNA levels and low plasma NGAL were significantly correlated with favorable renal outcomes at 6 months. The urine albumin-creatinine ratio (ACR) or urine protein-creatinine ratio (PCR) level is a robust predictor of cf-mtDNA and cf-nDNA in CKD patients. Baseline urine levels of cf-mtDNA and cf-nDNA could predict renal outcomes at 6 months. Urinary cf-mtDNA and cf-nDNA may provide novel prognostic biomarkers for renal outcome in CKD patients. The levels of plasma cf-nDNA and plasma NGAL are significantly correlated with the severity of CKD.