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Serum suPAR levels help differentiate steroid resistance from steroid-sensitive nephrotic syndrome in children

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Abstract

Background

Soluble urokinase plasminogen activator receptor (suPAR) has been regarded as a permeability factor in proteinuria, though its role in primary nephrotic syndrome remains to be elucidated further.

Methods

Plasma samples and clinical information from 176 children with primary nephrotic syndrome were collected and concentrations of suPAR were measured. We evaluated the correlation between suPAR concentrations and clinical features, and the value of the plasma suPAR level in predicting steroid-resistant nephrotic syndrome (SRNS).

Results

There is a significant difference in plasma suPAR concentration between SRNS and steroid-sensitive nephrotic syndrome (SSNS) groups (3,744.1 ± 2,226.0 vs. 2,153.5 ± 1,167.0, p < 0.05). The area under the curve (AUC) was 0.80, with p < 0.001 for the receiver operating characteristic (ROC) curve analysis using suPAR to predict SRNS. The suspicious range for predicting SRNS was estimated to be 1,907.0 pg/ml to 3,043.5 pg/ml (χ2 = 14.775, p = 0.001).

Conclusions

From ROC curve analysis, we demonstrated the significance of the suPAR level in predicting SRNS with a high specificity but low sensitivity. However, the clinical value of suPAR to predict steroid resistance and guide therapy remains to be investigated further.

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Acknowledgments

This project was supported by the National Natural Science Foundation of China (Grant Nos. 81270792, 81070561 and 81170664), the State “1025” Science and Technology Support Projects (2012BAI03B02), the Research Fund for the Doctoral Program of Higher Education of China (20120101110018), the Zhejiang Provincial Healthy Science Foundation of China (WKJ2010-2-014, 2012KYA119, 2014KYA123), the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents and the Zhejiang Provincial Natural Science Foundation of China (LY12H050037). We thank the patients and their family members for participating in this study.

Disclosure statement

No competing interests declared.

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Authors and Affiliations

  1. Department of Nephrology, The Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, China

    Zhaoyang Peng, Jianhua Mao, Weizhong Gu, Haidong Fu, Huijun Shen, Jingjing Wang, Xia Jin, Xiujuan Zhu, Aimin Liu, Qiang Shu & Lizhong Du

  2. Department of Clinical Laboratory, The Children’s Hospital of Zhejiang University School of Medicine, Hangzhou, 310003, China

    Zhaoyang Peng, Xuejun Chen & Fengqing Cai

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  1. Zhaoyang Peng
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  2. Jianhua Mao
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  13. Lizhong Du
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Correspondence to Jianhua Mao.

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Peng, Z., Mao, J., Chen, X. et al. Serum suPAR levels help differentiate steroid resistance from steroid-sensitive nephrotic syndrome in children. Pediatr Nephrol 30, 301–307 (2015). https://doi.org/10.1007/s00467-014-2892-6

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  • DOI: https://doi.org/10.1007/s00467-014-2892-6

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