Reno-protective mechanism by therapeutic intervention of metabolic acidosis on chronic kidney disease

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K08487
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General physiology
• Research Institution: Tohoku University
• Principal Investigator: Abe Michiaki 東北大学, 大学病院, 准教授 (40400246)
• Co-Investigator(Kenkyū-buntansha): 小柴 生造 東北大学, 東北メディカル・メガバンク機構, 教授 (70332301) ; 三枝 大輔 東北大学, 東北メディカル・メガバンク機構, 講師 (90545237)
• Research Collaborator: Shoji Mutsumi
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 慢性腎臓病 / 酸性尿

Outline of Final Research Achievements

The main findings of this study are described below;
1. As a result of quantitative metabolomic analysis of uremic toxins by LC-MS/MS of plasma and early-morning urine before and after alkalinizing agent intervention, urinary excretions of indoxyl sulfate, paracresyl sulfate and argininosuccinic acid were increased in Na/K citrate administration. And plasma levels of indoxyl sulfate was decreased.
2. The improvement of aciduria was observed by the administration of Na/K citrate, the renal function tended to be better as seen in the pH improvement of the spot urine was larger than that of early-morning urine. Na/K citric could be expected different mechanisms on renal protection effect other than alkalization from Na bicarbonate. It is considered this would be a new main stream of therapeutic strategies for chronic kidney disease.

Free Research Field

腎臓内科

Academic Significance and Societal Importance of the Research Achievements

本研究は、アルカリ性化剤は比較的軽症の慢性腎臓病・経度腎機能障害から腎保護効果を期待できるということを実証する目的で行われた。しかしながら、現時点では軽症の腎障害を鋭敏かつ適切に評価できる検査指標はない。本研究ではそのような腎障害マーカの探索も行っている。サンプル保存を維持するため単施設で進められたので、昨年12月で登録患者の検査データの収集が終了した。全研究データはモニタリング・クリーニングなどを経て3月31日に固定された。現在解析中。