Dynamics of d -serine reflected the recovery course of a patient with rapidly progressive glomerulonephritis

AbstractWe 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 ofd-serine in this patient. At the fulminant period of RPGN, the level of plasmad-serine, a potential biomarker in CKD that reflects actual glomerular filtration ratio (GFR), was extremely high. On the other hand, urinary fractional excretion (FE) ofd-serine, which was usually much higher than that ofl-isoform, was 0% in this patient. These abnormald-serine profiles normalized in response to the intensive treatment. Normalizations of bloodd-serine levels were in parallel with those of blood creatinine levels and potentially reflect the recovery of GFR. FE ofd-serine increased transiently before the normalization ofd-serine profile, suggesting that kidney promotes urinary excretion ofd-serine for the normalization of plasmad-serine level. These unexplored clinical features ofd-serine well reflected the clinical course of this patient. Bloodd-serine level can also serve as a biomarker in acute kidney injury (AKI) or RPGN, and, in combination with FE ofd-serine, may render the clinical practitioners to judge the efficacy of intensive treatments.
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research