Evaluation of nephrine and podocin as early biomarkers of proteinuria associated with the use of mTOR inhibitors in renal transplant patients
Renal transplantation is the treatment of choice for the majority of patients with chronic renal failure. After the patient is transplanted, prophylaxis of organ rejection is essential. Inhibitors of mTOR (mammalian target of rapamycin) have potent immunosuppressive and antiproliferative activity, allowing their successful inclusion in maintenance therapy regimens in transplant patients. However, reports from the literature show that some patients may develop proteinuria with the use of this class of medication. Although the etiology of this renal alteration is not elucidated, it has been suggested that this proteinuria would be associated with changes in the basal glomerular and basal membrane structure of these patients. Recently, the development of a new technique to concentrate the eliminated exosomes in the urine has allowed the quantification of small concentrations of cellular components carried in these microvesicles, such as, for example, proteins associated with podocytes, such as nephrin and podocin. In this perspective, it is important to investigate in renal transplant patients the potential role of nephrin and podocin proteins present in the urinary exosomes as sensitive biomarkers of glomerular damage in these patients
(Nephrin; podocin; mTOR inhibitors; kidney transplantation)