Níveis séricos, filtração e reabsorção renal do Fas solúvel (sFas) em indivíduos saudáveis e pacientes com Doença Renal Crônica

• Autor(a) principal: Dalboni, Maria Aparecida [UNIFESP]
• Data de Publicação: 2006
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://repositorio.unifesp.br/handle/11600/9838
• topic: Nefropatias; Clearance renal; mRNAsFas; Fas solúvel; RNA mensageiro

Increased serum soluble levels of Fas (sFas) have been reported in patients with chronic kidney disease (CKD). We sought to quantify the renal Clearance of sFas in healthy subjects and patients with CKD, to investigate whether sFas is reabsorbed after filtration and to investigate whether there is an increased synthesis of sFas. We studied 69 patients with CKD (creatinine clearance = 37+19 ml/min/1,73 m2) and 14 healthy control subjects. ELISA was used to measure sFas (pg/mL) and retinol Binding Protein (RBP - mg/L), as a marker of proximal tubule dysfunction and RT-PCR was used to quantify mRNAsFas (μg/μL). Serum sFas levels were significantly higher in patients with CKD (2781±1214 vs. 2196±773.; p=0.02). The levels of sFas in 24 hour urine samples (23±27 vs. 40±17; p = 0.006), sFas Clearance (0.019±0.022 vs. 0.036±0.020; p=0.01) and sFas excretion fraction (0.03±0.03 vs. 0.08±0.16, p = 0,009). were significantly lower in patients with CKD. sFas Clearance correlated with Creatinine Clearance (r=0.25, p=0.02). Urine levels of RBP correlated with sFas levels in the urine (r = 0.80, p < 0.001). mRNAsFas levels were higher in patients with CKD (3.9±1.8 vs. 2.5±0.9, p <0,001). In conclusion, we demonstrate that when renal function decreases, sFas Clearance decreases and sFas serum levels increase. In patients with proximal tubule dysfunction (high urinary RBP levels), urinary sFas is also increased, suggesting that sFas is reabsorbed by the proximal tubule. It is possible that an increase in sFas synthesis also contributes to the increase of serum sFas levels in uremia.