Urinary Plasminogen Activator Inhibitor-1: A Biomarker of Acute Tubular Injury.

American journal of nephrology 2021

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Acute kidney injury (AKI) is a threatening, multiaetiological syndrome encompassing a variety of forms and damage patterns. AKI lacks sufficiently specific diagnostic tools to evaluate the distinct combination of pathophysiological events underlying each case, which limits personalized and optimized handling. Therefore, a pathophysiological diagnosis based on new urinary biomarkers is sought for practical (readiness and noninvasiveness) and conceptual reasons, as the urine is a direct product of the kidneys. However, biomarkers found in the urine may also have extrarenal origin, thus conveying pathophysiological information from other organs or tissues. Urinary plasminogen activator inhibitor-1 (PAI-1) has been associated to AKI, although its origin and traffic to the urine are not known. Herein, we studied the blood or renal origin of urinary PAI-1 (uPAI-1) in experimental AKI in Wistar rats, by means of the in situ renal perfusion method. For this purpose, urine was collected while the kidneys of rats with AKI showing increased uPAI-1 excretion, and controls, were in situ perfused with a saline solution. Our results show that during perfusion, PAI-1 remained in the urine of AKI rats, suggesting that renal cells shed this protein directly to the urine. PAI-1 is also significantly increased in the urine of AKI patients. Its low correlation with other urinary markers such as NGAL or NAG suggests that PAI-1 provides complementary and distinct phenotypical information. In conclusion, uPAI-1 is a biomarker produced by damaged kidneys following AKI, whose precise pathophysiological meaning in AKI needs to be further investigated. © 2021 S. Karger AG, Basel.

Citation

María Paniagua-Sancho, Yaremi Quiros, Alfredo G Casanova, Víctor Blanco-Gozalo, Consuelo Agüeros-Blanco, Adalberto Benito-Hernández, María A Ramos-Barron, Carlos Gómez-Alamillo, Manuel Arias, Sandra M Sancho-Martínez, Francisco J López-Hernández. Urinary Plasminogen Activator Inhibitor-1: A Biomarker of Acute Tubular Injury. American journal of nephrology. 2021;52(9):714-724