Serum uromodulin and Roux-en-Y gastric bypass: improvement of a marker reflecting nephron mass

Background - Early diagnosis of kidney disease in obese patients and in such patients with type 2 diabetes (T2D) can significantly improve treatment outcome. Serum uromodulin (sUMOD) may be a sensitive parameter for early detection of nephropathy. - Objectives - To analyze sUMOD and traditional mark...

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Hauptverfasser: Scheurlen, Katharina (VerfasserIn) , Billeter, Adrian (VerfasserIn) , Kopf, Stefan (VerfasserIn) , Nawroth, Peter Paul (VerfasserIn) , Zeier, Martin (VerfasserIn) , Müller, Beat P. (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 15 May 2019
In: Surgery for obesity and related diseases
Year: 2019, Jahrgang: 15, Heft: 8, Pages: 1319-1325
ISSN:1878-7533
DOI:10.1016/j.soard.2019.05.002
Online-Zugang:Verlag, Volltext: https://doi.org/10.1016/j.soard.2019.05.002
Verlag: http://www.sciencedirect.com/science/article/pii/S1550728919301728
Volltext
Verfasserangaben:Katharina M. Scheurlen, M.D., Adrian T. Billeter, M.D., Ph.D., Stefan Kopf, M.D., Victor Herbst, Ph.D., Matthias Block, Ph.D., Peter P. Nawroth, M.D., Martin Zeier, M.D., Jürgen E. Scherberich, M.D., Beat P. Müller-Stich, M.D.

MARC

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245 1 0 |a Serum uromodulin and Roux-en-Y gastric bypass  |b improvement of a marker reflecting nephron mass  |c Katharina M. Scheurlen, M.D., Adrian T. Billeter, M.D., Ph.D., Stefan Kopf, M.D., Victor Herbst, Ph.D., Matthias Block, Ph.D., Peter P. Nawroth, M.D., Martin Zeier, M.D., Jürgen E. Scherberich, M.D., Beat P. Müller-Stich, M.D. 
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520 |a Background - Early diagnosis of kidney disease in obese patients and in such patients with type 2 diabetes (T2D) can significantly improve treatment outcome. Serum uromodulin (sUMOD) may be a sensitive parameter for early detection of nephropathy. - Objectives - To analyze sUMOD and traditional markers of kidney function in a cohort study of patients with and without obesity or T2D undergoing metabolic surgery compared with blood donors. - Setting - University of Heidelberg, Germany. - Methods - Patients with obesity (body mass index >35 kg/m2) without T2D (n = 10) and T2D (n = 10) and patients with nonsevere obesity (body mass index, 25-35 kg/m2) and insulin-dependent T2D (n = 16) undergoing Roux-en-Y gastric bypass (RYGB) were enrolled. The control group consisted of 190 blood donors. sUMOD was compared with established renal markers. - Results - Using sUMOD, impaired kidney function at baseline was present in both groups with T2D and in none of the patients with obesity without T2D. This impairment was not detectable through traditional markers. Significant improvement of sUMOD was shown in patients with obesity and T2D 12 months postoperatively (from 130.0 ± 77.5 to 239.5 ± 179.0 ng/mL; P = .004) and in patients with nonsevere obesity and T2D 6 months after RYGB (from 140.6 ± 78.0 to 298.7 ± 154.0 ng/mL; P = .017). In patients with obesity without T2D, sUMOD remained stable (P = .375). - Conclusions - sUMOD may serve as a tissue-specific biomarker in incipient diabetic nephropathy. Improvement of sUMOD after RYGB seems to profoundly restore the structural integrity of nephrons in these patients at risk for diabetic nephropathy. 
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