TY - JOUR
T1 - Dynamics of D-serine reflected the recovery course of a patient with rapidly progressive glomerulonephritis
AU - Hesaka, Atsushi
AU - Yasuda, Keiko
AU - Sakai, Shinsuke
AU - Yonishi, Hiroaki
AU - Namba-Hamano, Tomoko
AU - Takahashi, Atsushi
AU - Mizui, Masayuki
AU - Hamase, Kenji
AU - Matsui, Rakan
AU - Mita, Masashi
AU - Horio, Masaru
AU - Isaka, Yoshitaka
AU - Kimura, Tomonori
N1 - Funding Information:
A part of this study was funded by Shiseido Co., Ltd.
Funding Information:
This work was supported by grants from Takeda Science Foundation, from a Grant-in Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology (MEXT) and the Japan Society for the Promotion of Science (JSPS) (MEXT/JSPS KAKENHI Grant numbers 17H04188 to TK and YI), and in part by funds and technical supports from Shiseido Co., Ltd. for metabolite measurements.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - We experienced a case of a 36-year-old female with rapidly progressive glomerulonephritis (RPGN) due to anti-neutrophil cytoplasmic antibody (ANCA)-associated nephritis and systemic lupus erythematosus (SLE) nephritis. Chiral amino acid metabolomics revealed a prominent profile of D-serine in this patient. At the fulminant period of RPGN, the level of plasma D-serine, a potential biomarker in CKD that reflects actual glomerular filtration ratio (GFR), was extremely high. On the other hand, urinary fractional excretion (FE) of D-serine, which was usually much higher than that of L-isoform, was 0% in this patient. These abnormal D-serine profiles normalized in response to the intensive treatment. Normalizations of blood D-serine levels were in parallel with those of blood creatinine levels and potentially reflect the recovery of GFR. FE of D-serine increased transiently before the normalization of D-serine profile, suggesting that kidney promotes urinary excretion of D-serine for the normalization of plasma D-serine level. These unexplored clinical features of D-serine well reflected the clinical course of this patient. Blood D-serine level can also serve as a biomarker in acute kidney injury (AKI) or RPGN, and, in combination with FE of D-serine, may render the clinical practitioners to judge the efficacy of intensive treatments.
AB - We experienced a case of a 36-year-old female with rapidly progressive glomerulonephritis (RPGN) due to anti-neutrophil cytoplasmic antibody (ANCA)-associated nephritis and systemic lupus erythematosus (SLE) nephritis. Chiral amino acid metabolomics revealed a prominent profile of D-serine in this patient. At the fulminant period of RPGN, the level of plasma D-serine, a potential biomarker in CKD that reflects actual glomerular filtration ratio (GFR), was extremely high. On the other hand, urinary fractional excretion (FE) of D-serine, which was usually much higher than that of L-isoform, was 0% in this patient. These abnormal D-serine profiles normalized in response to the intensive treatment. Normalizations of blood D-serine levels were in parallel with those of blood creatinine levels and potentially reflect the recovery of GFR. FE of D-serine increased transiently before the normalization of D-serine profile, suggesting that kidney promotes urinary excretion of D-serine for the normalization of plasma D-serine level. These unexplored clinical features of D-serine well reflected the clinical course of this patient. Blood D-serine level can also serve as a biomarker in acute kidney injury (AKI) or RPGN, and, in combination with FE of D-serine, may render the clinical practitioners to judge the efficacy of intensive treatments.
UR - http://www.scopus.com/inward/record.url?scp=85083687547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083687547&partnerID=8YFLogxK
U2 - 10.1007/s13730-019-00411-6
DO - 10.1007/s13730-019-00411-6
M3 - Article
C2 - 31359345
AN - SCOPUS:85083687547
SN - 2192-4449
VL - 8
SP - 297
EP - 300
JO - CEN case reports
JF - CEN case reports
IS - 4
ER -