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Changes in sensory proteins in the bladder urothelium of patients with chronic kidney disease and end‐stage renal disease
Author(s) -
Chen ShengFu,
Lee ChengLing,
Kuo HannChorng
Publication year - 2019
Publication title -
luts: lower urinary tract symptoms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.451
H-Index - 15
eISSN - 1757-5672
pISSN - 1757-5664
DOI - 10.1111/luts.12240
Subject(s) - urothelium , medicine , end stage renal disease , kidney disease , urology , nephrology , purinergic receptor , receptor expression , overactive bladder , endocrinology , urinary bladder , receptor , pathology , disease , alternative medicine
Objective Patients with chronic kidney disease (CKD) or end‐stage renal disease (ESRD) frequently have lower urinary tract symptoms, such as frequency, urgency, or bladder pain. This study evaluated sensory protein expression in the bladder urothelium of patients with CKD or ESRD. Methods Twenty‐seven patients with ESRD or CKD and urodynamically proven detrusor underactivity (DU; n = 8) or bladder oversensitivity (n = 19) were enrolled in the study. These patients, and 10 controls, underwent cystoscopic biopsies of the urothelium. Western blotting analysis was used to examine the expression of sensory proteins, namely purinergic P2X 3 , muscarinic M 2 and M 3 , and β 3 ‐adrenergic (AR) receptors, as well as inducible (i) and epithelial (e) nitric oxide synthase (NOS), in tissue samples. Expression was compared between CKD or ESRD patients and controls. Results P2X 3 receptor expression was lower, whereas β 3 ‐AR was expression higher in the bladder urothelium of the patient group (ESRD and CKD combined) compared with controls. In addition, compared with controls, CKD patients had significantly lower P2X 3 receptor expression, whereas ESRD patients had significantly higher M 3 receptor expression. There were no significant differences in M 2 receptor, eNOS, and iNOS expression between ESRD or CKD patients and controls. Patients with DU had significantly higher M 2 and M 3 receptor expression. There were no significant differences in the expression of any protein between ESRD and CKD patients, regardless of the presence of bladder pain or anuria. Conclusion Significantly decreased P2X 3 receptor and increased β 3 ‐AR expression are seen in the bladder urothelium of patients with ESRD or CKD. The expression of these sensory proteins is not associated with decreased bladder capacity or anuria status in patients with ESRD or CKD.