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Jehn U, Kortenhorn A, Schütte-Nütgen K, Thölking G, Westphal F, Strauss M, Wennmann DO, Pavenstädt H, Suwelack B, Görlich D, Reuter S. The Influence of Parathyroidectomy on Osteoporotic Fractures in Kidney Transplant Recipients: Results from a Retrospective Single-Center Trial. J Clin Med 2022; 11:jcm11030654. [PMID: 35160109 PMCID: PMC8836679 DOI: 10.3390/jcm11030654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Kidney transplant (KTx) recipients are a high-risk population for osteoporotic fractures. We herein aim to identify the role of pre-transplant parathyroidectomy (PTX) and other modifiable factors associated with osteoporotic fractures in KTx recipients. We conducted a retrospective study involving 711 adult patients (4608 patient-years) who were transplanted at our center between January 2007 and June 2015. Clinical data were extracted from patients' electronic medical records. Different laboratory and clinical parameters for mineral bone disease (MBD) and osteoporosis, including medication, were evaluated. We chose fracture events unrelated to malignancies or adequate trauma as the primary endpoint. Osteoporotic fractures occurred in 47 (6.6%) patients (median 36.7 months, IQR 45.9) after KTx (fracture incidence of 10 per 1000 person-years). Prior to KTx, subtotal PTX was performed in 116 patients (16.3%, median time 4.2 years before KTx, IQR 5.0). Of the patients with fracture (n = 47), only one (2.2%) patient had previously undergone PTX. After adjusting for the known fracture risk factors MBD and osteoporosis, PTX remained a protective factor against fractures (HR 0.134, CI 0.018-0.991, p = 0.049). We observed a reduced risk for pathological fractures in KTx patients who underwent PTX, independent from elevated parathyroid hormone at the time of KTx or afterwards.
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Affiliation(s)
- Ulrich Jehn
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
- Correspondence: ; Tel.: +49-251-83-47540; Fax: +49-251-83-56973
| | - Anja Kortenhorn
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Katharina Schütte-Nütgen
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Gerold Thölking
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Florian Westphal
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Markus Strauss
- Department of Medicine C, Division of Cardiology and Angiology, University Hospital of Muenster, 48149 Muenster, Germany;
| | - Dirk-Oliver Wennmann
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Hermann Pavenstädt
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Barbara Suwelack
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany;
| | - Stefan Reuter
- Department of Medicine D, Division of General Internal Medicine, Nephrology and Rheumatology, University Hospital of Muenster, 48149 Muenster, Germany; (A.K.); (K.S.-N.); (G.T.); (F.W.); (D.-O.W.); (H.P.); (B.S.); (S.R.)
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Weide T, Vollenbröker B, Schulze U, Djuric I, Edeling M, Bonse J, Hochapfel F, Panichkina O, Wennmann DO, George B, Kim S, Daniel C, Seggewiß J, Amann K, Kriz W, Krahn MP, Pavenstädt H. Pals1 Haploinsufficiency Results in Proteinuria and Cyst Formation. J Am Soc Nephrol 2017; 28:2093-2107. [PMID: 28154200 DOI: 10.1681/asn.2016040474] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 01/03/2017] [Indexed: 12/30/2022] Open
Abstract
The nephron is the basic physiologic subunit of the mammalian kidney and is made up of several apicobasally polarized epithelial cell types. The process of apicobasal polarization in animal cells is controlled by the evolutionarily conserved Crumbs (CRB), Partitioning-defective, and Scribble protein complexes. Here, we investigated the role of protein associated with LIN-7 1 (Pals1, also known as Mpp5), a core component of the apical membrane-determining CRB complex in the nephron. Pals1 interacting proteins, including Crb3 and Wwtr1/Taz, have been linked to renal cyst formation in mice before. Immunohistologic analysis revealed Pals1 expression in renal tubular cells and podocytes of human kidneys. Mice lacking one Pals1 allele (functionally haploid for Pals1) in nephrons developed a fully penetrant phenotype, characterized by cyst formation and severe defects in renal barrier function, which led to death within 6-8 weeks. In Drosophila nephrocytes, deficiency of the Pals1 ortholog caused alterations in slit-diaphragm-like structures. Additional studies in epithelial cell culture models revealed that Pals1 functions as a dose-dependent upstream regulator of the crosstalk between Hippo- and TGF-β-mediated signaling. Furthermore, Pals1 haploinsufficiency in mouse kidneys associated with the upregulation of Hippo pathway target genes and marker genes of TGF-β signaling, including biomarkers of renal diseases. These findings support a link between apical polarity proteins and renal diseases, especially renal cyst diseases. Further investigation of the Pals1-linked networks is required to decipher the mechanisms underlying the pathogenesis of these diseases.
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Affiliation(s)
- Thomas Weide
- Internal Medicine D, University Hospital of Münster, Münster, Germany;
| | | | - Ulf Schulze
- Internal Medicine D, University Hospital of Münster, Münster, Germany
| | - Ivona Djuric
- Internal Medicine D, University Hospital of Münster, Münster, Germany
| | - Maria Edeling
- Internal Medicine D, University Hospital of Münster, Münster, Germany
| | - Jakob Bonse
- Internal Medicine D, University Hospital of Münster, Münster, Germany
| | - Florian Hochapfel
- Institute for Molecular and Cellular Anatomy, University of Regensburg, Regensburg, Germany
| | - Olga Panichkina
- Institute for Molecular and Cellular Anatomy, University of Regensburg, Regensburg, Germany
| | | | - Britta George
- Internal Medicine D, University Hospital of Münster, Münster, Germany
| | - Seonhee Kim
- Shriners Hospitals Pediatric Research Center, Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Christoph Daniel
- Nephropathology Department, Institute of Pathology, Erlangen-Nürnberg University, Erlangen, Germany
| | - Jochen Seggewiß
- Interdisciplinary Center for Clinical Research, University of Münster, Munster, Germany; and
| | - Kerstin Amann
- Nephropathology Department, Institute of Pathology, Erlangen-Nürnberg University, Erlangen, Germany
| | - Wilhelm Kriz
- Department of Neuroanatomy, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael P Krahn
- Institute for Molecular and Cellular Anatomy, University of Regensburg, Regensburg, Germany
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Duning K, Wennmann DO, Bokemeyer A, Reissner C, Wersching H, Thomas C, Buschert J, Guske K, Franzke V, Flöel A, Lohmann H, Knecht S, Brand SM, Pöter M, Rescher U, Missler M, Seelheim P, Pröpper C, Boeckers TM, Makuch L, Huganir R, Weide T, Brand E, Pavenstädt H, Kremerskothen J. Common exonic missense variants in the C2 domain of the human KIBRA protein modify lipid binding and cognitive performance. Transl Psychiatry 2013; 3:e272. [PMID: 23778582 PMCID: PMC3693407 DOI: 10.1038/tp.2013.49] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The human KIBRA gene has been linked to human cognition through a lead intronic single-nucleotide polymorphism (SNP; rs17070145) that is associated with episodic memory performance and the risk to develop Alzheimer's disease. However, it remains unknown how this relates to the function of the KIBRA protein. Here, we identified two common missense SNPs (rs3822660G/T [M734I], rs3822659T/G [S735A]) in exon 15 of the human KIBRA gene to affect cognitive performance, and to be in almost complete linkage disequilibrium with rs17070145. The identified SNPs encode variants of the KIBRA C2 domain with distinct Ca(2+) dependent binding preferences for monophosphorylated phosphatidylinositols likely due to differences in the dynamics and folding of the lipid-binding pocket. Our results further implicate the KIBRA protein in higher brain function and provide direction to the cellular pathways involved.
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Affiliation(s)
- K Duning
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - D O Wennmann
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - A Bokemeyer
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - C Reissner
- Department of Anatomy and Molecular Neurobiology, University Münster, Münster, Germany
| | - H Wersching
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - C Thomas
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - J Buschert
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - K Guske
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - V Franzke
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - A Flöel
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - H Lohmann
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - S Knecht
- Department of Neurology, University Hospital Münster, Münster, Germany
| | - S-M Brand
- Institute of Sports Medicine, University of Münster, Münster, Germany
| | - M Pöter
- Institute of Medical Biochemistry, Center for Molecular Biology of Inflammation, Münster, Germany
| | - U Rescher
- Institute of Medical Biochemistry, Center for Molecular Biology of Inflammation, Münster, Germany
| | - M Missler
- Department of Anatomy and Molecular Neurobiology, University Münster, Münster, Germany
| | - P Seelheim
- Institute of Biochemistry, University of Münster, Münster, Germany
| | - C Pröpper
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - T M Boeckers
- Institute of Anatomy and Cell Biology, University Ulm, Ulm, Germany
| | - L Makuch
- Howard Hughes Medical Center, John Hopkins University, Baltimore, MD, USA
| | - R Huganir
- Howard Hughes Medical Center, John Hopkins University, Baltimore, MD, USA
| | - T Weide
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - E Brand
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - H Pavenstädt
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany
| | - J Kremerskothen
- Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Münster, Germany,Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany. E-mail:
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