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Vitamin B is potential way to treat acute kidney injury

By Allen Cone   |   Aug. 20, 2018 at 12:35 PM
This is an image of a patient who died with acute kidney injury -- with the darker areas showing surviving medullary tissue. Researchers found a form of vitamin B3 has the potential to treat acute kidney injury. Photo by Haymanj/Wikimedia Commons

Aug. 20 (UPI) -- A form of vitamin B3 has the potential to treat acute kidney injury, according to a study.

Researchers at Beth Israel Deaconess Medical Center in Boston found that levels of nicotinamide adenine dinucleotide, which are the end result of vitamin B3 after ingestion, declines in acute kidney injury cases. They published their findings Monday in the journal Nature Medicine.

"These findings are very early, but the results suggest that we could one day have a non-invasive test for NAD+ status and perhaps even treat acute kidney injury by boosting NAD+ levels," principal investigator Dr. Samir M. Parikh, an associate professor of medicine at Harvard Medical School, said in a press release.

With acute kidney injury, there is a buildup of waste products in the blood and an imbalance of fluids throughout the body.

During hospitalization, especially in intensive-care units, acute kidney injury can occur from ailments that place the body into extreme stress.

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The number of hospitalizations with acute kidney injury numbered nearly 4 million compared with nearly 1 million in 2000, according to the Centers for Disease Control and Prevention.

The researchers were able to detect a drop in NAD+ in the urine of high-risk patients in an intensive- care unit or undergoing a major surgery.

"Our results suggest that NAD+ biosynthesis becomes impaired during human acute kidney injury and that augmenting vitamin B3 levels may be safe and potentially beneficial to patients," clinical trial co-leader Dr. Kamal Khabbaz, chief of cardiac Surgery at the CardioVascular Institute at BIDMC, said. "What's more, we showed that urinary measurements in at-risk patients can indicate this impairment and, furthermore, predict adverse outcomes."

In a urine screen, there were high levels of quinolinate, a little-studied intermediate for making NAD+.

A block of an enzyme called QPRT might be responsible for converting quinolinate to NAD+.

Because of the blockage of QPRT, the researchers believe this is linked to NAD+ depletion during acute kidney injury, which disrupts the body's ability to manufacture NAD+.

High urinary quinolinate was found in patients undergoing major surgery at risk for acute kidney injury.

In an ensuing study of 329 intensive-care patients at the Boston hospital also at risk for acute kidney injury, the team found high urinary quinolinate in patients undergoing major surgery at risk for acute kidney injury. The team then gave large doses of oral vitamin B3 to 41 cardiac surgery patients enrolled in a phase 1 pilot study, and it showed to be effective.