{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:54:20Z","timestamp":1790927660502,"version":"4.1.0"},"reference-count":41,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Nephrol"],"abstract":"<jats:p>Introduction: Galectin-9, a \u03b2-galactoside-binding protein, is elevated in various kidney diseases. While exogenous galectin-9 attenuates kidney injury in experimental models, it remains unclear whether endogenous plasma galectin-9 reflects renal histopathology and independently predicts long-term adverse outcomes in chronic kidney disease (CKD). Methods: Plasma galectin-9 levels were prospectively measured in 366 participants from the Taipei Renal Transcriptomics and Outcomes Investigation (TRTOI) cohort. Renal histopathology and chronicity were assessed using a modified Mayo Clinic Chronicity Score (MCCS). Major adverse renal events (MAREs) were defined as \u226540% decline in estimated glomerular filtration rate (eGFR), kidney failure, or death. Findings were validated in 549 participants from the Boston Kidney Biopsy Cohort (BKBC). In vitro, mouse mesangial cells (SV40-MES-13) were used to evaluate galectin-9 effects on TGF-\u03b2-induced mesangial activation. Results: Transcriptomic analysis showed upregulation of LGALS9 (encoding galectin-9) in fibrotic kidneys. Plasma galectin-9 positively correlated with urine protein-to-creatinine ratio and MCCS and inversely with eGFR. Elevated galectin-9 was independently associated with mesangial expansion. In vitro, exogenous galectin-9 attenuated TGF-\u03b2-induced mesangial cell activation, proliferation, and profibrotic responses; these effects were reversed by lactose, a competitive inhibitor of the carbohydrate recognition domains of galectin-9. In the TRTOI cohort, participants in the highest galectin-9 tertile had a significantly increased risk of MAREs, independent of confounders. Validation in the BKBC confirmed that higher galectin-9 levels were independently associated with increased all-cause mortality. Conclusion: Elevated plasma galectin-9 is associated with mesangial expansion and predicts a higher risk of MAREs in patients with CKD.<\/jats:p>","DOI":"10.1159\/000552954","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:00:44Z","timestamp":1785340844000},"page":"1-13","source":"Crossref","is-referenced-by-count":0,"title":["Galectin-9 as a Circulating Marker of Mesangial Injury and Prognosis in Biopsy-Proven Kidney 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