Serpin-A3 is Associated with Persistent Albuminuria in Adolescents with Secondary Podocytopathy, in a Region with High Prevalence of Chronic Kidney Disease of Unknown Origin

Abstract Background: The state of Aguascalientes, Mexico, has been recognized as a chronic kidney disease hotspot. Screening studies have revealed a high prevalence of persistent albuminuria (pA), histologically characterized by glomerulomegaly, and incomplete podocyte fusion, probably associated with oligonephrony. To date, urinary biomarkers have not been explored in this population. Objective: The aim of the study was to identify the presence of potential biomarkers of early renal injury in patients with pA (pACR) and that correspond with the characteristic nephropathy profile that prevails in this entity. Methods: This is a cross-sectional, analytical, and comparative study. Four groups were recruited: adolescents aged 10-17 years with pACR, isolated albuminuria (iACR), no albuminuria (negative control), and adults with biopsy-confirmed glomerulopathy (positive control). Urinary excretion of SerpinA3, heat-shock protein-72 (HSP-72), podocalyxin (PCX), and nephrin was evaluated in urine samples. SerpinA3 and HSP-72 were analyzed by Western blot, and PCX and nephrin were quantified by enzyme-linked immunosorbent assay. Results: The mean GFR in the pACR group was 113.4 mL/min/1.73m2 and differed significantly only from that of the positive control group (65.1 mL/min/1.73m2). The mean albuminuria value in the pACR group was 48.9 mg/g. SerpinA3 concentration differed between groups (0.08 vs. 0.25 ng/mL, p < 0.001): it was significantly higher in the pACR group compared to the negative controls (p = 0.037). Conclusion: SerpinA3 was significantly associated with pA and could become a biomarker of early kidney injury. Further investigations are required to determine whether SerpinA3 precedes the development of albuminuria and its pathogenic role.

Relaciones Intrafamiliares y Riesgo de Suicidio de Estudiantes Mexicanos de Bachillerato / Intra-Family Relationships and Suicide Risk in Mexican Highschool Students

Resumen La cantidad de muertes por suicidio en México aumenta en promedio 2.35% cada año y se concentra en los grupos de edad de 15 a 24 años. Aunque se sabe que múltiples factores familiares intervienen en el comportamiento suicida de los adolescentes, las formas de evaluarlos han sido heterogéneos. El objetivo fue identificar la relación entre las relaciones intrafamiliares y el riesgo de suicidio en estudiantes de un bachillerato de Aguascalientes. Se implementó un diseño correlacional con muestra tipo censo mediante el uso de las escalas de Plutchik de riesgo suicida y Relaciones Intrafamiliares, cuyas subescalas evalúan unión y apoyo, expresión y dificultades. La información se analizó mediante estadísticas descriptivas, de correlación y regresión lineal. De los 946 participantes se encontró riesgo suicida en casi 20%, predominando las mujeres. Se encontró una relación significativa entre el riesgo suicida y las tres subescalas de relaciones intrafamiliares, aunque sólo Expresión y Dificultades mantuvieron esa correlación en el modelo de regresión lineal. Se concluye que la dinámica familiar en que se desarrollan los jóvenes influye en el riesgo suicida, aunque no constituya causa suficiente. Se sugiere considerar variables psicosociales y usar instrumentos adaptados a cada población en el estudio del suicidio adolescente.

Abstract The number of deaths by suicide in Mexico increases an average of 2.35% each year, concentrating mainly on the age groups of 15 to 24 years. Although multiple family factors are known to play a role in adolescent suicidal behavior, the ways in which they are assessed have been heterogeneous. The objective was to identify the relationship between the components of intrafamily relationships and the risk of suicide in high school students in Aguascalientes. A correlational investigation was implemented, with a census-type sample design using scales: Plutchik's suicide risk and Intrafamily Relationships conformed bay expression, union and difficulties subscales. The information was analyzed with the SPSS program using descriptive statistics, correlation and linear regression. Of the 946 participants, suicidal risk was found in almost 20%, predominantly women. A moderate but significant relationship was found between suicide risk and the three subscales of intrafamily relationships, although only two of them, Expression and Difficulties, maintained this correlation when incorporated together with the other variables to a linear regression model. It is concluded that the family dynamics in which young people develop influences suicide risk. It´s suggest to consider psychosocial variables and adapted scales in the adolescent suicide studies.