Nuclear Factor Erythroid 2-Related Factor 2 (Nrf2) and Nuclear Factor-Kappa B (NF- κB) Expression in Chronic Kidney Disease Patients (CKD) from South India

Aim: The present study elucidated the expression level of Nrf2 and NF-κB, in chronic kidney disease (CKD) patients from South India. Further, the expression levels of these genes are analyzed for cytokines TNF-α and IFN-γ and various subgroups of cases including dialysis, non-dialysis, diabetic and non-diabetic CKD patients, and correlation analysis performed. Methods: 133 CKD patients and 133 healthy individuals were enrolled for the evaluation of NF-κB and Nrf2 expression by qPCR. Results: Upregulated Nrf2 mRNA expression (as fold change) was observed in diabetic (Fc: 1.13), and non-diabetic (Fc: 1.30) patients. Inversely, Nrf2 mRNA expression was down regulated in non-dialysis groups (Fc: 0.80). NF-κB expression was significantly upregulated in non-diabetic (Fc:1.92), non-dialysis (Fc:1.59), dialysis (Fc: 1.36) and CKD patients (pooled) (Fc: 1.27). A dysregulated NF-κB expression was observed in diabetic groups (Fc: 0.69). Nrf2 mRNA expression were positively correlated with IFN-γ expression in diabetes (r = 0.28, p = 0.05) and non-diabetic CKD patients (r = 0.37, p < 0.002). Likewise, TNF-α expression was positively correlated with Nrf2 expression in CKD (pooled) patients (r = 0.33, p < 0.000). A negative correlation was observed in Nrf2 and NF-κB expression in CKD (pooled) (r = -0.028, p = 0.833). Conclusion: The study concluded the down regulated Nrf2 and upregulated NF-κB expressions in non-dialysis patients. On the contrary, in diabetic CKD patients, the expression level of NF-κB was downregulated and Nrf2 was upregulated. Thus, a negative correlation was observed between Nrf2 and NF-κB genes with respect to their expression patterns.