Establishment of the scoring system for predicting the prognosis of CKD patients.

慢性肾脏病（CKD）患者的数量在全球范围内不断增加，并随之出现终末期肾衰竭，这是一个全球性的公共卫生问题。目前的筛查策略，基于肌酐或白蛋白尿，未能确定相当数量的CKD受试者。我们首先从各种CKD患者中分离外泌体。然后，我们研究了足细胞衍生的外泌体转录因子（PDETFs）的表达在尿中的各种CKD患者与总蛋白尿。虽然白蛋白尿的程度没有差异，但进展性肾脏疾病（如糖尿病肾病）表现出高水平的尿PDETFs。肾小球PDETFs的表达随着患者尿液中PDETFs的量而降低。尿PDETFs分泌量越高，肾功能下降越早。PDETFs的检测和分析将为进一步了解CKD和CVD之间的分子联系提供线索。

The worldwide rise in the number of patients with chronic kidney disease (CKD) and consequent end-stage renal failure is a global public health problem. Current screening strategies, based on creatinine or albuminuria, fail to identify a considerable number of subjects with CKD. We first isolate exosomes from various CKD patients. We then examined the expression of podocyte-derived exosomal transcriptional factors (PDETFs) in urine from various CKD patients with gross proteinuria. While extent of albuminuria was not different, progressing renal diseases such as diabetic nephropathy exhibited high levels of urinary PDETFs. Glomerular expression of PDETFs was decreased in accordance with the amount of PDETFs in urine of the patients. The higher amount of urinary PDETFs secreted, the earlier the renal function declined. Evaluation and analysis of PDETFs would provide some clues to understanding the molecular linkage between CKD and CVD.