Characterization of Glomerular and Tubulointerstitial Proteomes in a Case of NSAID-Attributed Acute Kidney Injury

Clin J Am Soc Nephrol. 2022 Nov 7;CJN.09260822. doi: 10.2215/CJN.09260822. Online ahead of print.

Abstract

The major goals of the Kidney Precision Medicine Project (KPMP) are to establish a molecular atlas of the kidney in health and disease and improve our understanding of the molecular drivers of chronic kidney disease and acute kidney injury. In this clinical-pathological-molecular correlation, we describe the case of a 38-year-old woman without any prior history of chronic kidney disease who underwent a research kidney biopsy in the setting of acute kidney injury suspected to be due to non-steroidal anti-inflammatory use following cesarean section delivery. The participant's histopathology was consistent with mild acute tubular injury, without significant interstitial fibrosis or tubular atrophy. This diagnosis was supported by analysis of the glomerular and tubulointerstitial proteomes. The proteomic interrogation revealed a molecular landscape that demonstrated differences in kidney prostaglandin synthesis that may be in response to NSAIDs, as well as signs of intra-renal inflammation and fibrosis that were not evident by histopathology alone.