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      The metabolomic quest for a biomarker in chronic kidney disease

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      Author(s):
      Publication date (Electronic):
      Journal: Clinical Kidney Journal
      Publisher: Oxford University Press
      Keywords: biomarkers, chronic kidney disease, diet, metabolomics

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          ABSTRACT

          Chronic kidney disease (CKD) is a growing burden on people and on healthcare for which the diagnostics are niether disease-specific nor indicative of progression. Biomarkers are sought to enable clinicians to offer more appropriate patient-centred treatments, which could come to fruition by using a metabolomics approach. This mini-review highlights the current literature of metabolomics and CKD, and suggests additional factors that need to be considered in this quest for a biomarker, namely the diet and the gut microbiome, for more meaningful advances to be made.

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          Intestinal Short Chain Fatty Acids and their Link with Diet and Human Health

          David Ríos-Covián, Patricia Ruas-Madiedo, Abelardo Margolles … (2016)
          The colon is inhabited by a dense population of microorganisms, the so-called “gut microbiota,” able to ferment carbohydrates and proteins that escape absorption in the small intestine during digestion. This microbiota produces a wide range of metabolites, including short chain fatty acids (SCFA). These compounds are absorbed in the large bowel and are defined as 1-6 carbon volatile fatty acids which can present straight or branched-chain conformation. Their production is influenced by the pattern of food intake and diet-mediated changes in the gut microbiota. SCFA have distinct physiological effects: they contribute to shaping the gut environment, influence the physiology of the colon, they can be used as energy sources by host cells and the intestinal microbiota and they also participate in different host-signaling mechanisms. We summarize the current knowledge about the production of SCFA, including bacterial cross-feedings interactions, and the biological properties of these metabolites with impact on the human health.
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            Innovation: Metabolomics: the apogee of the omics trilogy.

            Gary J Patti, Oscar Yanes, Gary Siuzdak (2012)
            Metabolites, the chemical entities that are transformed during metabolism, provide a functional readout of cellular biochemistry. With emerging technologies in mass spectrometry, thousands of metabolites can now be quantitatively measured from minimal amounts of biological material, which has thereby enabled systems-level analyses. By performing global metabolite profiling, also known as untargeted metabolomics, new discoveries linking cellular pathways to biological mechanism are being revealed and are shaping our understanding of cell biology, physiology and medicine.
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              Functional status of elderly adults before and after initiation of dialysis.

              Manjula Kurella Tamura, Kenneth E. Covinsky, Glenn Chertow … (2009)
              It is unclear whether functional status before dialysis is maintained after the initiation of this therapy in elderly patients with end-stage renal disease (ESRD). Using a national registry of patients undergoing dialysis, which was linked to a national registry of nursing home residents, we identified all 3702 nursing home residents in the United States who were starting treatment with dialysis between June 1998 and October 2000 and for whom at least one measurement of functional status was available before the initiation of dialysis. Functional status was measured by assessing the degree of dependence in seven activities of daily living (on the Minimum Data Set-Activities of Daily Living [MDS-ADL] scale of 0 to 28 points, with higher scores indicating greater functional difficulty). The median MDS-ADL score increased from 12 during the 3 months before the initiation of dialysis to 16 during the 3 months after the initiation of dialysis. Three months after the initiation of dialysis, functional status had been maintained in 39% of nursing home residents, but by 12 months after the initiation of dialysis, 58% had died and predialysis functional status had been maintained in only 13%. In a random-effects model, the initiation of dialysis was associated with a sharp decline in functional status, indicated by an increase of 2.8 points in the MDS-ADL score (95% confidence interval [CI], 2.5 to 3.0); this decline was independent of age, sex, race, and functional-status trajectory before the initiation of dialysis. The decline in functional status associated with the initiation of dialysis remained substantial (1.7 points; 95% CI, 1.4 to 2.1), even after adjustment for the presence or absence of an accelerated functional decline during the 3-month period before the initiation of dialysis. Among nursing home residents with ESRD, the initiation of dialysis is associated with a substantial and sustained decline in functional status. 2009 Massachusetts Medical Society
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Kidney J
                Journal ID (iso-abbrev): Clin Kidney J
                Journal ID (publisher-id): ckj
                Title: Clinical Kidney Journal
                Publisher: Oxford University Press
                ISSN (Print): 2048-8505
                ISSN (Electronic): 2048-8513
                Publication date (Print): October 2018
                Publication date (Electronic): 02 June 2018
                Publication date PMC-release: 02 June 2018
                Volume: 11
                Issue: 5
                Pages: 694-703
                Affiliations
                School of Biomedical and Healthcare Sciences, University of Plymouth School of Biological Sciences, Plymouth, UK
                Author notes
                Correspondence and offprint requests to: Robert Davies; E-mail: robert.davies-8@ 123456students.plymouth.ac.uk
                Author information
                http://orcid.org/0000-0002-6549-0579
                Article
                Publisher ID: sfy037
                DOI: 10.1093/ckj/sfy037
                PMC ID: 6165760
                PubMed ID: 30288265
                SO-VID: 323b3dc1-8fd1-46f1-8209-ae9a5cfdc0d8
                Copyright © © The Author(s) 2018. Published by Oxford University Press on behalf of ERA-EDTA.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Date received : 23 January 2018
                Date accepted : 16 April 2018
                Page count
                Pages: 10
                Categories
                Subject: CKD

                ScienceOpen disciplines: Nephrology
                Keywords: biomarkers,chronic kidney disease,diet,metabolomics
                Data availability:
                ScienceOpen disciplines: Nephrology
                Keywords: biomarkers, chronic kidney disease, diet, metabolomics

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