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The association of RNA-binding protein Human antigen R with kidney clinicopathologic features and renal outcomes in patients with diabetic nephropathy

  • Author Footnotes
    1 Co-first authors of this study.
    Jiaxin Dong
    Footnotes
    1 Co-first authors of this study.
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Author Footnotes
    1 Co-first authors of this study.
    Simeng Liu
    Footnotes
    1 Co-first authors of this study.
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Qing Li
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Lin Wu
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Chengning Zhang
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Suyan Duan
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Bo Zhang
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Yanggang Yuan
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Author Footnotes
    2 Correspondence authors contributedequallyto this article.
    Zhimin Huang
    Correspondence
    Corresponding authors.
    Footnotes
    2 Correspondence authors contributedequallyto this article.
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Author Footnotes
    2 Correspondence authors contributedequallyto this article.
    Changying Xing
    Correspondence
    Corresponding authors.
    Footnotes
    2 Correspondence authors contributedequallyto this article.
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
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  • Author Footnotes
    2 Correspondence authors contributedequallyto this article.
    Huijuan Mao
    Correspondence
    Corresponding authors.
    Footnotes
    2 Correspondence authors contributedequallyto this article.
    Affiliations
    Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing 210029, China
    Search for articles by this author
  • Author Footnotes
    1 Co-first authors of this study.
    2 Correspondence authors contributedequallyto this article.
Published:November 04, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110142

      Abstract

      Aims

      RNA-binding protein Human antigen R (HuR) is closely related to diabetic nephropathy (DN) pathogenesis. However, the capacity of histological HuR level as a biomarker for DN progression remains unclear.

      Methods

      A total of 147 patients with type 2 diabetes mellitus who had biopsy-proven DN were enrolled. Renal outcomes were defined by doubling serum creatinine level or progression to end-stage renal disease (ESRD). A nomogram was built to predict renal outcomes based on Cox proportional hazards regression.

      Results

      The median follow-up period was 31 months, during which 71 (48.30 %) patients confronted DN progression. Pearson’s correlation indicated that histological HuR increased along with DN pathological class rising (r = 0.776, p < 0.001). Notably, multivariate Cox regression analysis showed that elevated HuR was associated with a greater risk of DN progression (HR 2.431, 95 %CI: 1.275–4.634, p = 0.007) beyond 6 months after renal biopsy. Patients in the higher HuR expression group had lower cumulative renal survival rates beyond the first 6 months. Simultaneously, a well-performed nomogram including HuR classification, was developed to predict the individual progression risk (C-index 0.828).

      Conclusions

      Our findings demonstrated that the histologic HuR expression was an independent risk factor for kidney progression beyond 6 months after renal biopsy in DN.

      Keywords

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