Association of indexes of autophagy, apoptosis and intracellular protein degradation with body composition in chronic kidney disease patients, treated by program dialysis: results of longitudinal prospective study

The aim: to study the relationship of autophagy activity, apoptosis and intracellular protein degradation with body composition in patients with chronic kidney disease 5d.

Patients and methods. A cohort prospective study was performed on 106 adult patients with chronic kidney disease 5d receiving programmed hemodialysis treatment. The data of clinical and anamnestic

Original articles Clinical investigations (complaints, anamnesis), physical (objective examination) and laboratory (Beclin-1, 20S proteasome, Bcl-2) examinations were studied. The latter is performed on the “RADIM analyzer” (USA) using the ELISA kits (“Cloud-Clone Corp.”, USA).

Results. In 80 patients, the activity of autophagy (Beclin-1), intracellular protein degradation (20S-proteasome) and apoptosis (Bcl-2), which was classified into clusters, was determined: “high activity” Beclin-1 was 2.4 ± 0.4 ng / ml, "low activity" - 1.4 ± 0.2 ng / ml; similar clusters of 20S-proteasomes - 62.0 ± 7.1 ng / ml and 31.9 ± 6.7 ng / ml; Bcl-2 - 4.2 ± 0.6 ng / ml and 1.8 ± 0.5 ng / ml, respectively (p <0.05). The low activity of Beclin-1 and the high 20S proteasome and Bcl-2 corresponded to a low lean mass. The low activity of Beclin-1 corresponded to a low indicator of total water. The low activity of the 20S proteasome and Bcl-2 corresponded to a high total water content. The low activity of Beclin-1 corresponded to a low total fluid volume. The low activity of the 20S proteasome and Bcl-2 corresponded to a high total fluid volume. The increase in fluid volume was due to both intracellular and extracellular water.

Conclusion. Patients with CKD 5d stages are characterized by a decrease in the activity of autophagy, apoptosis and intracellular protein degradation due to intracellular energy deficiency. The influence of autophagy, apoptosis and protein degradation on the indicators of lean mass, total water and total fluid volume is accompanied by the simultaneous activation of one process and inhibition of another.

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