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| Item Type: | Article |
|---|---|
| Title: | Flow-cytometric quantification of urine kidney epithelial cells specifically reflects tubular damage in acute kidney diseases |
| Creators Name: | Wagner, L., Kujat, J., Langhans, V., Prskalo, L., Metzke, D., Grothgar, E., Freund, P., Goerlich, N., Brand, H., Timm, S., Ochs, M., Grützkau, A., Baumgart, S., Skopnik, C.M., Schreiber, A., Hiepe, F., Riemekasten, G., Enghard, P. and Klocke, J. |
| Abstract: | INTRODUCTION: Tubular injury is one of the main mechanisms driving acute kidney injury (AKI); however, clinicians still have a limited diagnostic repertoire to precisely monitor damage to tubular epithelial cells (TECs). In our previous study, we used single-cell sequencing to identify TEC subsets as the main components of the urine signature of AKI. This study aimed to establish TECs as clinical markers of tubular damage. METHODS: A total of 243 patients were analyzed. For sequencing, we collected 8 urine samples from patients with AKI and glomerular disease. We developed a protocol for the flow cytometric quantification of CD10/CD13(+) proximal TECs (PTECs) and CD227/CD326(+) distal TECs (DTECs) in urine by aligning urinary single-cell transcriptomes and TEC surface proteins using Cellular Indexing of Transcriptome and Epitope Sequencing (CITE-Seq). Marker combinations were confirmed in kidney biopsies. We validated our approach in 4 cohorts of 235 patients as follows: patients with AKI (n = 63), COVID-19 infection (n = 47), antineutrophil cytoplasmic autoantibody (ANCA)–associated vasculitis (AAV) with active disease or stable remission (n = 110), and healthy controls (n = 15). RESULTS: Our findings demonstrated that CD10/CD13 and CD227/CD326 adequately identified PTECs and DTECs, respectively. Distal urinary TEC counts correlate with the severity of AKI based on Kidney Disease: Improving Global Outcomes (KDIGO) stage and acute estimated glomerular filtration rate (GFR) loss in 2 separate cohorts and can successfully discriminate AKI from healthy controls and glomerular disease. CONCLUSION: We propose that urinary CD227/CD326(+) TEC count is a specific, noninvasive marker for tubular injury in AKI. Our protocol provides a basis for a deeper phenotypic analysis of urinary TECs. |
| Keywords: | Acute Kidney Injury, ANCA-Associated Vasculitis, Flow Cytometry, Single-Cell Sequencing, Tubular Epithelial Cells, Urinalysis |
| Source: | Kidney International Reports |
| ISSN: | 2468-0249 |
| Publisher: | Elsevier |
| Date: | 3 February 2025 |
| Official Publication: | https://doi.org/10.1016/j.ekir.2025.01.037 |
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