Cystatin C-Based eGFR Predicts Post-Treatment Kidney Prognosis in Patients with Severe Obstructive Nephropathy

A discrepancy between serum concentrations of cystatin C (CysC) and creatinine (sCr) has been reported in patients with acute obstructive nephropathy. However, the usefulness of CysC for predicting the recovery of kidney function in patients with severe obstructive nephropathy remains unclear. We examined the predictability of the estimated glomerular filtration rate calculated with CysC or sCr (eGFRcys or eGFRcreat) for the post-treatment recovery of kidney function. We retrospectively collected patients with severe obstructive nephropathy (eGFRcreat 2) whose baseline sCr and CysC were measured between 48 h before and 24 h after the release of urinary tract obstruction (UTO). The primary outcome was recovery from severe eGFRcreat depression (i.e., eGFRcreat ≥ 30 mL/min/1.73 m2) 7 days after the release of UTO. We calculated the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the relationship between eGFRcys or eGFRcreat and recovery. Thirty-four patients (20 males) with a median age of 76 years were eligible. We identified 20 recovery cases. The AUCs of the ROC curves (95% confidence interval) for eGFRcys and eGFRcreat were 0.81 (0.66–0.96) and 0.53 (0.32–0.73), respectively. These results imply cystatin C-based eGFR may help predict kidney prognosis in patients with severe obstructive nephropathy

Cystatin C-Based eGFR Predicts Post-Treatment Kidney Prognosis in Patients with Severe Obstructive Nephropathy

A discrepancy between serum concentrations of cystatin C (CysC) and creatinine (sCr) has been reported in patients with acute obstructive nephropathy. However, the usefulness of CysC for predicting the recovery of kidney function in patients with severe obstructive nephropathy remains unclear. We examined the predictability of the estimated glomerular filtration rate calculated with CysC or sCr (eGFRcys or eGFRcreat) for the post-treatment recovery of kidney function. We retrospectively collected patients with severe obstructive nephropathy (eGFRcreat < 30 mL/min/1.73 m2) whose baseline sCr and CysC were measured between 48 h before and 24 h after the release of urinary tract obstruction (UTO). The primary outcome was recovery from severe eGFRcreat depression (i.e., eGFRcreat ≥ 30 mL/min/1.73 m2) 7 days after the release of UTO. We calculated the area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the relationship between eGFRcys or eGFRcreat and recovery. Thirty-four patients (20 males) with a median age of 76 years were eligible. We identified 20 recovery cases. The AUCs of the ROC curves (95% confidence interval) for eGFRcys and eGFRcreat were 0.81 (0.66–0.96) and 0.53 (0.32–0.73), respectively. These results imply cystatin C-based eGFR may help predict kidney prognosis in patients with severe obstructive nephropathy

Effects of BEIIb-Deficiency on the Cluster Structure of Amylopectin and the Internal Structure of Starch Granules in Endosperm and Culm of Japonica-Type Rice

It is known that one of starch branching enzyme (BE) isoforms, BEIIb, plays a specific role not only in the synthesis of distinct amylopectin cluster structure, but also in the formation of the internal structure of starch granules in rice endosperm because in its absence the starch crystalline polymorph changes to the B-type from the typical A-type found in the wild-type (WT) cereal endosperm starch granules. In the present study, to examine the contribution of BEIIb to the amylopectin cluster structure, the chain-length distributions of amylopectin and its phosphorylase-limit dextrins (Φ-LD) from endosperm and culm of a null be2b mutant called amylose-extender (ae) mutant line, EM10, were compared with those of its WT cultivar, Kinmaze, of japonica rice. The results strongly suggest that BEIIb specifically formed new short chains whose branch points were localized in the basal part of the crystalline lamellae and presumably in the intermediate between the crystalline and amorphous lamellae of amylopectin clusters in the WT endosperm, whereas in its absence branch points which were mainly formed by BEI were only located in the amorphous lamellae of amylopectin. These differences in the cluster structure of amylopectin between Kinmaze and EM10 endosperm were considered to be responsible for the differences in the A-type and B-type crystalline structures of starch granules between Kinmaze and EM10, respectively. The changes in internal structure of starch granules caused by BEIIb were analyzed by wide angle X-ray diffraction, small-angle X-ray scattering, solid state ^C NMR, and optical sum frequency generation spectroscopy. It was noted that the size the amylopectin cluster in ae endosperm (approximately 8.24 nm) was significantly smaller than that in WT endosperm (approximately 8.81 nm). Based on the present results, we proposed a model for the cluster structure of amylopectin in WT and ae mutant of rice endosperm. We also hypothesized the role of BEIIa in amylopectin biosynthesis in culm where BEIIb was not expressed and instead BEIIa was the major BE component in WT of rice