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Title: The soluble urokinase receptor is not a clinical marker for focal segmental glomerulosclerosis
Authors: Meijers, Bj√∂rn ×
Maas, Rutger J H
Sprangers, Ben
Claes, Kathleen
Poesen, Ruben
Bammens, Bert
Naesens, Maarten
Deegens, Jeroen K J
Dietrich, Ruth
Storr, Markus
Wetzels, Jack F M
Evenepoel, Pieter
Kuypers, Dirk #
Issue Date: Mar-2014
Publisher: Nature Pub. Group
Series Title: Kidney International vol:85 issue:3 pages:636-40
Article number: 10.1038/ki.2013.505
Abstract: The soluble urokinase receptor (suPAR) promotes proteinuria and induces focal segmental glomerulosclerosis (FSGS)-like lesions in mice. A serum suPAR concentration cutoff of 3000 pg/ml has been proposed as a clinical biomarker for patients with FSGS. Interestingly, several studies in patients with glomerulopathy found an inverse correlation between the estimated glomerular filtration rate (eGFR) and suPAR. As patients with FSGS present at different eGFRs, we studied the relationship between eGFR and suPAR in a cohort of 476 non-FSGS patients and 54 patients with biopsy-proven idiopathic FSGS. In the non-FSGS patients, eGFR was the strongest significant determinant of suPAR. The proposed cutoff for suPAR in FSGS patients was exceeded in 17%, 39%, and 88% in patients with eGFRs of more than 60, 45-60, and 30-45 ml/min per 1.73 m(2), respectively. In patients with eGFR of <30 ml/min per 1.73 m(2), suPAR exceeded the cutoff in 95% of patients. Levels of suPAR in patients with idiopathic FSGS overlapped with non-FSGS controls and for any given eGFR did not discriminate FSGS cases from non-FSGS controls. In the overall cohort, there was a negative association between idiopathic FSGS and suPAR, and idiopathic FSGS was not an independent predictor of FSGS concentration over 3000 pg/ml. Thus, this study does not support an absolute, eGFR-independent, suPAR concentration cutoff as a biomarker for underlying FSGS pathology and questions the validity of relative, eGFR-dependent suPAR cutoff values.Kidney International advance online publication, 8 January 2014; doi:10.1038/ki.2013.505.
URI: 
ISSN: 0085-2538
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Nephrology
× corresponding author
# (joint) last author

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