Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka: Hematological Changes and Pro-Inflammation Suggest Likely Predictors of Advance Disease, as Renal Outcomes Show Prevalent Normoalbuminuria

Diseases

P. G. Chandra L. Nanayakkara¹  K. B. Suneetha Gunawickrama²  K. Imesha G. Hewavitharana³  S. H. Nandana P. Gunawickrama³ 

[1]Department of Anatomy, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka

[2]Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka

[3]Institute for Combinatorial Advance Research and Education, General Sir John Kotelawala Defence University, Ratmalana 10390, Sri Lanka

关键词: chronic kidney disease of unknown etiology;    chronic kidney disease development;    hematology;    nonproteinuria;    monocyte chemoattractant protein-1;    interleukin-6;   

DOI  :  10.3390/diseases10010002

来源: DOAJ

【 摘 要 】

CKDu needs to be characterized in fundamental areas to improve etiological understanding and disease management. In a cross-sectional study, blood cell profile and plasma inflammatory cytokines were followed by automated analysis and sandwich ELISA, respectively. Disease development stages and proteinuria were ascertained by eGFR and UACR. Comparison among control and stages (ANOVA/Dunnett’s MRT) revealed time-specific changes (p < 0.05), including decreased erythrocytes (G5) and hematocrit (G5), and increased MCHC (G3b, G4), MCV (G5), and MCH (G5). CKDu decreased (p < 0.05) lymphocytes (G3b, G4, G5), monocytes (G3b), MPV (G3b, G4, G5), and plateletcrit (G3b, G4), and increased basophils (G3a, G3b, G4), N/L (G4) and PLR (G4–G5). MCHC and aforesaid leukocyte variables were in correlation (rho > ±0.03, p < 0.05, Pearson’s test) with disease development. MCP-1 and IL-6 spiked (p > 0.05) at G3b. Multivariate analyses confirmed that MCP-1, lymphocytes, and BMI were related to renal dysfunction, pointing to inflammation, compromised immunity, and muscle wasting as CKDu effects. Nonproteinuric CKDu was prevalent (23.2–35.6% of total CKDu) with (p < 0.05) elevated basophils (G3a), N/L (G4), and depleted lymphocytes (G4). In both forms, G1–G2 were unaffected, and the earliest change was G3a basophils. Results suggest that MCP-1, lymphocyte count, N/L, and PLR may verify the stage and predict impending ESRD in advance proteinuric CKDu.

【 授权许可】

Unknown