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At least 235 records · Page 13

Status of the International Space Station Waste and Hygiene Compartment

The Waste and Hygiene Compartment (WHC) serves as the primary system for removal and containment of metabolic waste and hygiene activities on board the United States segment of the International Space Station (ISS). The WHC was launched on ULF 2 and is currently in the U.S. Laboratory and is integrated into the Water Recovery System (WRS) where pretreated urine is processed by the Urine Processor Assembly (UPA). The waste collection part of the WHC system is derived from the Service Module system and was provided by RSC-Energia along with additional hardware to allow for urine delivery to the UPA. The System has been integrated in an ISS standard equipment rack structure for use on the U.S. segment of the ISS. The system has experienced several events of interest during the deployment, checkout, and operation of the system during its first year of use and these will be covered in this paper. Design and on-orbit performance will also be discussed.

Walker, Stephanie↗

International Space Station Water Balance Operations

In November 2008, the Water Regenerative System racks were launched aboard Space Shuttle flight, STS-126 (ULF2) and installed and activated on the International Space Station (ISS). These racks, consisting of the Water Processor Assembly (WPA) and Urine Processor Assembly (UPA), completed the installation of the Regenerative (Regen) Environmental Control and Life Support Systems (ECLSS), which includes the Oxygen Generation Assembly (OGA) that was launched 2 years prior. With the onset of active water management on the US segment of the ISS, a new operational concept was required, that of water balance . In November of 2010, the Sabatier system, which converts H2 and CO2 into water and methane, was brought on line. The Regen ECLSS systems accept condensation from the atmosphere, urine from crew, and processes that fluid via various means into potable water, which is used for crew drinking, building up skip-cycle water inventory, and water for electrolysis to produce oxygen. Specification (spec) rates of crew urine output, condensate output, O2 requirements, toilet flush water, and drinking needs are well documented and used as the best guess planning rates when Regen ECLSS came online. Spec rates are useful in long term planning, however, daily or weekly rates are dependent upon a number of variables. The constantly changing rates created a new challenge for the ECLSS flight controllers, who are responsible for operating the ECLSS systems onboard ISS from Mission Control in Houston. This paper reviews the various inputs to water planning, rate changes, and dynamic events, including but not limited to: crew personnel makeup, Regen ECLSS system operability, vehicle traffic, water storage availability, and Carbon Dioxide Removal Assembly (CDRA), Sabatier, and OGA capability. Along with the inputs that change the various rates, the paper will review the different systems, their constraints, and finally the operational challenges and means by which flight controllers manage this new concept of "water balance."

Tobias, Barry↗

Latent Virus Reactivation in Space Shuttle Astronauts

Latent virus reactivation was measured in 17 astronauts (16 male and 1 female) before, during, and after short-duration Space Shuttle missions. Blood, urine, and saliva samples were collected 2-4 months before launch, 10 days before launch (L-10), 2-3 hours after landing (R+0), 3 days after landing (R+14), and 120 days after landing (R+120). Epstein-Barr virus (EBV) DNA was measured in these samples by quantitative polymerase chain reaction. Varicella-zoster virus (VZV) DNA was measured in the 381 saliva samples and cytomegalovirus (CMV) DNA in the 66 urine samples collected from these subjects. Fourteen astronauts shed EBV DNA in 21% of their saliva samples before, during, and after flight, and 7 astronauts shed VZV in 7.4% of their samples during and after flight. It was interesting that shedding of both EBV and VZV increased during the flight phase relative to before or after flight. In the case of CMV, 32% of urine samples from 8 subjects contained DNA of this virus. In normal healthy control subjects, EBV shedding was found in 3% and VZV and CMV were found in less than 1% of the samples. The circadian rhythm of salivary cortisol measured before, during, and after space flight did not show any significant difference between flight phases. These data show that increased reactivation of latent herpes viruses may be associated with decreased immune system function, which has been reported in earlier studies as well as in these same subjects (data not reported here).

Mehta, S. K.↗

Development of a Universal Waste Management System

A concept for a Universal Waste Management System (UWMS) has been developed based on the knowledge gained from over 50 years of space travel. It is being designed for Commercial Orbital Transportation Services (COTS) and Multi ]Purpose Crew Vehicle (MPCV) and is based upon the Extended Duration Orbiter (EDO) commode. The UMWS was modified to enhance crew interface and reduce volume and cost. The UWMS will stow waste in fecal canisters, similar to the EDO, and urine will be stowed in bags for in orbit change out. This allows the pretreated urine to be subsequently processed and recovered as drinking water. The new design combines two fans and a rotary phase separator on a common shaft to allow operation by a single motor. This change enhances packaging by reducing the volume associated with an extra motor, associated controller, harness, and supporting structure. The separator pumps urine to either a dual bag design for COTS vehicles or directly into a water reclamation system. The commode is supported by a concentric frame, enhancing its structural integrity while further reducing the volume from the previous design. The UWMS flight concept development effort is underway and an early output of the development will be a ground based UMWS prototype for manned testing. Referred to as the Gen 3 unit, this prototype will emulate the crew interface included in the UWMS and will offer a great deal of knowledge regarding the usability of the new design, allowing the design team the opportunity to modify the UWMS flight concept based on the manned testing.

Baccus, Shelley↗

Results for the Brine Evaporation Bag (BEB) Brine Processing Test

The recent Brine Processing Test compared the NASA Forward Osmosis Brine Dewatering (FOBD), Paragon Ionomer Water Processor (IWP), UMPQUA Ultrasonic Brine Dewatering System (UBDS), and the NASA Brine Evaporation Bag (BEB). This paper reports the results of the BEB. The BEB was operated at 70 deg C and a base pressure of 12 torr. The BEB was operated in a batch mode, and processed 0.4L of brine per batch. Two different brine feeds were tested, a chromic acid-urine brine and a chromic acid-urine-hygiene mix brine. The chromic acid-urine brine, known as the ISS Alternate Pretreatment Brine, had an average processing rate of 95 mL/hr with a specific power of 5kWhr/L. The complete results of these tests will be reported within this paper.

BEB↗

Metabolomic and Genomic Markers of Atherosclerosis as Related to Oxidative Stress, Inflammation, and Vascular Function in Twin Astronauts

BACKGROUND: Future human space travel will consist primarily of long-duration missions onboard the International Space Station (ISS) or exploration-class missions to Mars, its moons, or nearby asteroids. Astronauts participating in long-duration missions may be at an increased risk of oxidative stress and inflammatory damage due to radiation, psychological stress, altered physical activity, nutritional insufficiency, and hyperoxia during extravehicular activity. By studying one identical twin during his 1-year ISS mission and his ground-based twin, this work extends a current NASA-funded investigation to determine whether these spaceflight factors contribute to an accelerated progression of atherosclerosis. This study of twins affords a unique opportunity to examine spaceflight-related atherosclerosis risk that is independent of the confounding factors associated with different genotypes. PURPOSE: The purpose of this investigation was to determine whether biomarkers of oxidative and inflammatory stress are elevated during and after long-duration spaceflight and determine if a relation exists between levels of these biomarkers and structural and functional indices of atherosclerotic risk measured in the carotid and brachial arteries. These physiological and biochemical data will be extended by using an exploratory approach to investigate the relationship between intermediate phenotypes and risk factors for atherosclerosis and the metabolomic signature from plasma and urine samples. Since metabolites are often the indirect products of gene expression, we simultaneously assessed gene expression and DNA methylation in leukocytes. HYPOTHESIS: We predict that, compared to the ground-based twin, the space-flown twin will experience elevated biomarkers of oxidative stress and inflammatory damage, altered arterial structure and function, accelerated telomere shortening, dysregulation of genes associated with oxidative stress and inflammation, and a metabolic profile shift that is associated with elevated atherosclerosis risk factors. METHODS: In the space-flown twin, a panel of biomarkers of oxidative and inflammatory stress were measured in venous blood samples and in 24-h (in-flight) and 48-h (pre- and post-flight) urine pools collected twice before flight, six times during the mission (~FD15, 75, 180, 240, 300, 335), and early in the post-flight recovery phase (3-5 days after landing). We also measured metabolomic (targeted and untargeted approaches) and genomic markers (DNA methylation, mRNA gene expression, telomere length) in these samples. Arterial structure, assessed from measures of intima-media thickness, also were measured using standard clinical ultrasound at the same time points. Arterial function was assessed using brachial flow-mediated dilation, a well-validated measure used to assess endothelium-dependent vasodilation and a sensitive predictor of atherosclerotic risk, only before and after spaceflight. All of the same measures were obtained in the ground-based twin, but less frequently. DISCUSSION: All data collection has been completed for both the space-flown twin and the ground-based twin. Vascular structure and function measures have been analyzed, blood and urine samples have been batch-processed. Results from these individuals will be compared to each other, to data from other Twin Study investigations, and to the larger complement of subjects participating in the companion study currently ongoing in ISS astronauts.

Lee, Stuart M. C.↗

Getting Out of Orbit: Water Recycling Requirements and Technology Needs for Long Duration Missions Away from Earth

Deep-space crewed missions will not have regular access to the Earth's resources or the ability to rapidly return to Earth if a system fails. As crewed missions extend farther from Earth for longer periods, habitation systems must become more self-sufficient and reliable for safe, healthy, and sustainable human exploration. For human missions to Mars, Environmental Control and Life Support Systems (ECLSS) must be able operate for up to 1,100 days with minimal spares and consumables. These missions will require capabilities to more fully recycle atmospheric gases and wastewater to substantially reduce mission costs. Even with relatively austere requirements for use, water represents one of the largest consumables by mass. Systems must be available to extract and recycle water from all sources of waste. And given that there will be no opportunity to send samples back to Earth for analysis, analytical measurements will be limited to monitoring hardware brought on board the spacecraft. The Earth Reliant phase of NASA's exploration strategy includes leveraging the International Space Station (ISS) to demonstrate advanced capabilities for a robust and reliable ECLSS. The ISS Water Recovery System (WRS) includes a Urine Processor Assembly (UPA) for distillation and recovery of water from urine and a Water Processor Assembly (WPA) to process humidity condensate and urine distillate into potable water. Possible enhancements to more fully "close the water loop" include recovery of water from waste brines and solid wastes. A possible game changer is the recovery of water from local planetary resources through use of In Situ Resource Utilization (ISRU) technologies. As part of the development and demonstration sequence, NASA intends to utilize cis-Lunar space as a Proving Ground to verify systems for deep space habitation by conducting extended duration missions to validate our readiness for Mars.

Barta, Daniel J.↗

Forecasting the Change of Renal Stone Occurrence Rates in Astronauts

Changes in urine chemistry, during and post flight, potentially increases the risk of renal stones in astronauts. Although much is known about the effects of space flight on urine chemistry, no inflight incidences of renal stones in US astronauts exists and the question How much does this risk change with space flight? remains difficult to accurately quantify. In this discussion, we tackle this question utilizing a combination of deterministic and probabilistic modeling that implements the physics behind free stone growth and agglomeration, speciation of urine chemistry and published observations of population renal stone incidences to estimate changes in the rate of renal stone occurrence.

physiological response↗

Challenges with Operating a Water Recovery System (WRS) in the Microgravity Environment of the International Space Station (ISS)

The ISS WRS produces potable water from crew urine, crew latent, and Sabatier product water. This system has been operational on ISS since November 2008, producing over 30,000 L of water during that time. The WRS includes a Urine Processor Assembly (UPA) to produce a distillate from the crew urine. This distillate is combined with the crew latent and Sabatier product water and further processed by the Water Processor Assembly (WPA) to the potable water. The UPA and WPA use technologies commonly used on ISS for water purification, including filtration, distillation, adsorption, ion exchange, and catalytic oxidation. The primary challenge with the design and operation of the WRS has been with implementing these technologies in microgravity. The absence of gravity has created unique issues that impact the constituency of the waste streams, alter two-phase fluid dynamics, and increases the impact of particulates on system performance. NASA personnel continue to pursue upgrades to the existing design to improve reliability while also addressing their viability for missions beyond ISS.

Carter, Donald Layne↗

Ground Test Validations for Uncrewed Dormancy Preparation and Recovery

In future long duration space flight and habitation missions, periods of uncrewed dormancy where life support systems are shutdown or in low power-modes will occur. To examine the impacts of these dormant periods, along with potential pre- and post-dormancy procedures, Marshall Space Flight Center has been building an uncrewed dormancy test stand. The uncrewed dormancy test stand will include a urine separator from the Universal Waste Management System, a condensate separator, urine filter, brine filter and distillate filter. In conjunction to the test stand, the Center for Biofilm Engineering (CBE) has ongoing long-term dormancy experiments to assess microbial survival in a variety of simulated shutdown procedures including shut-in, flushing with and without biocide, and dry-out conditions. This publication will serve as a discussion of dormancy considerations, criteria for success, and experimental designs for testing dormancy conditions and shutdown procedures. It will include an update of ongoing test stand construction, including a description of the current lower-fidelity versions of the urine and condensate separators being produced. It will also examine dormancy work being conducted by the CBE and discuss how this may factor into procedures tested on the uncrewed dormancy test stand.

Eric Beitle↗

Numerical Characterization of Astronaut CaOx Renal Stone Incidence Rates to Quantify In-flight and Post-flight Relative Risk

Changes in urine chemistry potentially alter the risk of renal stone formation in astronauts. Quantifying spaceflight renal stone incidence risk compared to pre-flight levels remains a significant challenge for assessing the appropriate vehicle, mission, and countermeasure design. A computational biochemistry model representing CaOx crystal precipitation, growth, and agglomeration is combined with a probabilistic analysis to predict the in- and post-flight CaOx renal stone incidence risk ratio (IRR) relative to pre-flight values using 1517 astronaut 24-hour urine chemistries. Our simulations predict that in-flight fluid intake alone would need to increase from current prescriptions of 2.0 - 2.5 L/day to approximately 3.2 L/day to approach CaOx IRR of the pre-flight population. Bone protective interventions would reduce CaOx risk to pre-flight levels if Ca excretion alone is reduced to < 150 mg/day or if current levels are diminished to 190mg/day in combination with increasing fluid intake to 2.5 - 2.7 L/day. This analysis provides a quantitative risk assessment that can influence the critical balance between engineering and astronaut health requirements.

renal stones↗

Bio-distribution and deposition of wildfire smoke chemicals into olfactory bulb and brain of rats after intranasal instillation

Epidemiological and experimental studies suggest wildfire smoke is a potential contributor to neurological dysfunction and associated with neuroinflammation. Using doses comparable to those encountered during intense wildfire events (200-300 μg/m 3 ), we explore the absorption, distribution, metabolism, and elimination (ADME) and pharmacokinetics of representative members of major chemical classes (acid, phenol, PAH, aldehyde) in inhaled wood smoke condensates. Male Sprague Dawley rats were intranasally instilled with smoldering eucalyptus woodsmoke extract (WSE) reconstituted in saline spiked with 14 C-labeled palmitic acid (PA), benzo[a]pyrene (B[a]P), catechol (CAT) or benzaldehyde (BZ). Serum was collected from 5 min to 2 weeks after exposure and tissues were collected at 0.5, 2, 4, 24 h and 2 weeks after exposure. Urine was collected over the 24 h exposure. Tissues were collected, rinsed in PBS and analyzed by accelerator mass spectrometry (AMS) for 14C-labeled chemicals. PA and B[a]P entered circulation slowly, reached maximum concentration (C max ) near 15 ng/mL at 2 h, and had circulating concentrations near 1/3 C max 24 h after exposure. CAT and BZ rapidly entered circulation and were mostly cleared at 2 h. Excess 14 C from all four chemicals was detected in olfactory bulb and brain over the first 24 h but only PA (or its metabolites) was retained in olfactory bulb, brain and kidney at 2 weeks post exposure. All excess 14 C was cleared from the lung at 2 weeks. Metabolite analysis of urine (CAT, BZ and B(a)P) dosed samples did not detect any parent compound. CAT and BZ were rapidly cleared. The slower uptake and clearance of PA or B[a]P or their reactive metabolites when dosed with WSE in brain and olfactory bulb potentially provide greater opportunity for inflammatory response. This study suggests that wildfire smoke chemicals can enter the brain directly from the nasal cavity to the olfactory bulb and via systemic circulation.

63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTAN↗

Translating dosimetry of Dibenzo[ def,p ]chrysene (DBC) and metabolites across dose and species using physiologically based pharmacokinetic (PBPK) modeling

We report that Dibenzo[def,p]chrysene (DBC) is an environmental polycyclic aromatic hydrocarbon (PAH) that causes tumors in mice and has been classified as a probable human carcinogen by the International Agency for Research on Cancer. Animal toxicity studies often utilize higher doses than are found in relevant human exposures. Additionally, like many PAHs, DBC requires metabolic bioactivation to form the ultimate toxicant, and species differences in DBC and DBC metabolite metabolism have been observed. To understand the implications of dose and species differences, a physiologically based pharmacokinetic model (PBPK) for DBC and major metabolites was developed in mice and humans. Metabolism parameters used in the model were obtained from experimental in vitro metabolism assays using mice and human hepatic microsomes. PBPK model simulations were evaluated against mice dosed with 15 mg/kg DBC by oral gavage and human volunteers orally microdosed with 29 ng of DBC. DBC and its primary metabolite DBC-11,12-diol were measured in blood of mice and humans, while in urine, the majority of DBC metabolites were obeserved as conjugated DBC-11,12-diol, conjugated DBC tetrols, and unconjugated DBC tetrols. The PBPK model was able to predict the time course concentrations of DBC, DBC-11,12-diol, and other DBC metabolites in blood and urine of human volunteers and mice with reasonable accuracy. Agreement between model simulations and measured pharmacokinetic data in mice and human studies demonstrate the success and versatility of our model for interspecies extrapolation and applicability for different doses. Furthermore, our simulations show that internal dose metrics used for risk assessment do not necessarily scale allometrically, and that PBPK modeling provides a reliable approach to appropriately account for interspecies differences in metabolism and physiology.

59 BASIC BIOLOGICAL SCIENCES↗

Enhancing Resource Recovery through Electro-Assisted Regeneration of an Ammonia-Selective Cation Exchange Resin

Ammonia-selective adsorbents can manage reactive nitrogen in the environment and promote a circular nutrient economy. Weak acid cation exchangers loaded with zinc exhibit high ammonia selectivity but face two implementation barriers: the stability of the zinc–carboxylate bond in complex wastewaters and energy- and logistics-intensive adsorbent regeneration with acidic solutions. In this paper, we examined the stability of zinc–carboxylate bonds in varying solutions (pure ammonium solution, synthetic urine, and real urine) and during electro-assisted regeneration. For electrochemical regeneration, both electrolyte concentration and current density influenced the trade-off between ammonia regeneration and zinc elution. Using 10 mM K 2 SO 4 anolyte at a 0.08 mA/cm 2 current density, we achieved 4% zinc elution and 61% ammonia regeneration. In contrast, using 100 mM K 2 SO 4 at 4.96 mA/cm 2 improved the regeneration efficiency to 97% but eluted 60% of zinc. We found that electrolyte concentration was the key factor influencing the regeneration efficiency of the NH 3 -selective adsorbents. Due to prevalent zinc elution, we designed an in situ procedure for reforming the zinc–carboxylate bond and achieved similar adsorption densities between pre- and post-regenerated resins, thus enabling multiple cycle resin use. Ultimately, this study advances understanding of ammonia-selective resins that can facilitate high-purity, selective, and durable recovery of nutrients from waste streams.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Four-decade follow-up of a plutonium-contaminated puncture wound treated with Ca-DTPA

Contaminated wounds are a common route of internal deposition of radionuclides for nuclear and radiation workers. They may result in significant doses to radiosensitive organs and tissues in an exposed individual's body. The United States Transuranium and Uranium Registries' whole-body donor (Case 0303) accidentally punctured his finger on equipment contaminated with plutonium nitrate. The wound was surgically excised and medically treated with intravenous injections of Ca-DTPA. A total of 16 g Ca-DTPA was administered in 18 treatments during the 2 months following the accident. Ninety-three urine samples were collected and analysed over 14 years following the accident. An estimated 239 Pu activity of 73.7 Bq was excreted during Ca-DTPA treatment. Post-mortem radiochemical analysis of autopsy tissues indicated that 40 years post-accident 21.6 ± 0.2 Bq of 239 Pu was retained in the skeleton, 12.2 ± 0.3 Bq in the liver, and 3.7 ± 0.1 Bq in other soft tissues; 1.35 ± 0.02 Bq of 239 Pu was measured in tissue samples from the wound site. To estimate the plutonium intake, late urine measurements, which were unaffected by chelation, and post-mortem radiochemical analysis results were evaluated using the IMBA Professional Plus software. The application of the National Council on Radiation Protection and Measurements wound model with an assumption of intake material as a predominantly strongly retained soluble plutonium compound with a small insoluble fraction adequately described the data (p = 0.46). The effective intake was estimated to be 50.2 Bq of plutonium nitrate and 1.5 Bq of the fragment. Here, the prompt medical intervention with contaminated tissue excision and subsequent Ca-DTPA decorporation therapy reduced 239 Pu activity available for uptake and long-term retention in this individual's systemic organs by a factor of 38.

239Pu↗

URINARY EXCRETION OF PLUTONIUM IN MAYAK WORKERS DURING AND AFTER CA-DTPA ADMINISTRATION

Chelation therapy is sometimes used after potential exposures to plutonium to increase urinary excretion of the radionuclide to improve the accuracy of bioassay measurements. The purpose of this report is to describe the enhancement of urinary excretion of plutonium during and after the administration of the trisodium salt of calcium diethylenetriaminepentaacetate (Ca-DTPA) daily for 3 d to a group of male and female plutonium workers from the Mayak Production Association in Ozyorsk, Russia. One-hundred and two cases (18 females and 84 males) were selected where urinary contents of plutonium, prior to chelation, exceeded the detection threshold. Daily urine collections were obtained during the 3 d of Ca-DTPA treatments. In addition, 58 of these cases had urine bioassays at 1–45 d after chelation. The daily enhancement over baseline values excretion of plutonium was found to be 50.4×/1.4 (geometric mean and geometric standard deviation); 58.9×/1.2; 72.9×/1.4 in the first, second and third days of Ca-DTPA administration. The mean enhancement for the 3-d period was 60.1×/1.7. The rate of plutonium excretion from 1 to 45 d after chelation decreased with a half-period of 3.9 d and the chelation enhancement factor (Кenh-i) is described by the function Кenh-i = (0.79 ± 0.24) + (42.9 ± 1.2) × e-(0.18 ± 0.01) × day.

Environmental Sciences & Ecology↗

Modeling Plutonium Decorporation in a Female Nuclear Worker Treated with Ca-DTPA after Inhalation Intake

The present work models plutonium (Pu) biokinetics in a female former nuclear worker. Her bioassay measurements are available at the US Transuranium and Uranium Registries. The worker was internally exposed to a plutonium-americium mixture via acute inhalation at a nuclear weapons facility. She was medically treated with injections of 1 g Ca-DTPA on days 0, 5, and 14 after the intake. Between days 0 and 20, fecal and urine samples were collected and analyzed for 239 Pu and 241 Am. Subsequently, she was followed up for bioassay monitoring over 14 y, with additional post-treatment urine samples collected and analyzed for 239 Pu. The uniqueness of this dataset is due to the availability of: (1) both early and long-term bioassay data from a female with plutonium intake; (2) data on chelation therapy for a female; and (3) fecal measurement results. Chelation therapy with Ca- and/or Zn-salts of DTPA is known to aid in reducing the internal radiation dose by enhancing the excretion of plutonium and americium from the body. Such enhancement affects plutonium biokinetics in the human body, posing a challenge to the internal dose assessment. The current radiation dose assessment practice is to exclude the data affected by Ca-DTPA from the analysis. The present analysis is the first to explicitly model the chelation-affected bioassay data in a female by using a newly developed chelation model. Thus, the bioassay data collected during and after the Ca-DTPA administrations were used for biokinetic modeling and dose assessment. The Markov Chain Monte Carlo method was used to investigate model parameter uncertainty, based on the bioassay data and assumed prior probability distributions. A χ 2 /nData (number of data points) ≈ 1 was observed in this study, which indicates self-consistency of the data with the model. Results of this study show that the worker’s 239 Pu intake was 12 Bq, with a committed effective dose to the whole-body of 1.2 mSv and a committed equivalent dose to the bone surfaces, liver, and lungs of 37.8, 9.1, and 0.8 mSv, respectively. This study also discusses the worker’s dose reduction due to chelation treatment.

61 RADIATION PROTECTION AND DOSIMETRY↗

Endogenous adenine mediates kidney injury in diabetic models and predicts diabetic kidney disease in patients

Diabetic kidney disease (DKD) can lead to end-stage kidney disease (ESKD) and mortality, however, few mechanistic biomarkers are available for high-risk patients, especially those without macroalbuminuria. Urine from participants with diabetes from Chronic Renal Insufficiency Cohort (CRIC), Singapore Study of Macro-Angiopathy and Reactivity in Type 2 Diabetes (SMART2D), and the Pima Indian Study determined if urine adenine/creatinine ratio (UAdCR) could be a mechanistic biomarker for ESKD. ESKD and mortality were associated with the highest UAdCR tertile in CRIC (HR 1.57, 1.18, 2.10) and SMART2D (HR 1.77, 1.00, 3.12). ESKD was associated with the highest UAdCR tertile in patients without macroalbuminuria in CRIC (HR 2.36, 1.26, 4.39), SMART2D (HR 2.39, 1.08, 5.29), and Pima Indian study (HR 4.57, CI 1.37-13.34). Empagliflozin lowered UAdCR in non-macroalbuminuric participants. Spatial metabolomics localized adenine to kidney pathology and transcriptomics identified ribonucleoprotein biogenesis as a top pathway in proximal tubules of patients without macroalbuminuria, implicating mammalian target of rapamycin (mTOR). Adenine stimulated matrix in tubular cells via mTOR and stimulated mTOR in mouse kidneys. A specific inhibitor of adenine production was found to reduce kidney hypertrophy and kidney injury in diabetic mice. We propose that endogenous adenine may be a causative factor in DKD.

60 APPLIED LIFE SCIENCES↗