NRF2 and NF-κB MRNA Expression in Chronic Kidney Disease: a Focus on Nondialysis Patients

Purpose: To evaluate nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kappaB (NF-κB) mRNA expression in nondialysis chronic kidney disease (CKD) patients, comparing with data from hemodialysis (HD) patients and healthy individuals.

Methods: Twenty nondialysis CKD patients (62.0 ± 8.1 years old, 11 men, estimated glomerular filtration rate of 36.8 ± 13.6 mL/min/1.73 m(2)), twenty HD patients (55.0 ± 15.2 years old, 13 men, and dialysis vintage of 76.5 ± 46.3 months) and eleven healthy individuals (50.9 ± 8.0 years old, 6 men) were enrolled in the study. The peripheral blood mononuclear cells were isolated and processed for the evaluation of expression of NF-κB and Nrf2 by quantitative real-time polymerase chain reaction.

Results: Nrf2 mRNA expression was significantly higher in nondialysis (1.12 ± 0.57) when compared to HD patients (0.58 ± 0.35, p = 0,006) but similar to healthy individuals (1.13 ± 0.64). Inversely, NF-κB mRNA expression was lower in nondialysis (1.21 ± 0.71) when compared to HD patients (2.08 ± 0.7, p < 0.0001) and similar to healthy individuals (1.04 ± 0.22). Nrf2 mRNA was positively correlated with NF-κB mRNA expression in nondialysis CKD patients (r = 0.52, p = 0.02) and healthy individuals (r = 0.77, p < 0.006). By contrast, Nrf2 mRNA was inversely correlated with NF-κB mRNA expression (r = -0.65, p = 0.003) in HD patients.

Conclusion: Nondialysis CKD patients may conserve regular homeostatic balance between Nrf2 and NF-κB expressions, being comparable to healthy individuals. However, HD patients seem to have Nrf2 downregulation and NF-κB upregulation. Thus, the association among Nrf2 and NF-κB expressions and nutritional status, kidney disease progression or immune deregulation deserve further investigation.