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Clinical significance of serum and urinary soluble urokinase receptor (suPAR) in primary nephrotic syndrome and MPO-ANCA-associated glomerulonephritis in Japanese

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Abstract

Background

The soluble urokinase receptor (suPAR) has been implicated as a cause of primary focal segmental glomerulosclerosis (FSGS). However, the clinical significance of suPAR in glomerular diseases currently remains unclear.

Methods

In this retrospective single-center cohort study, we investigated serum (s-) and urinary (u-) suPAR in patients with primary nephrotic syndrome (NS) (serum/urine: 37/32 cases) and MPO-ANCA-associated glomerulonephritis (ANCA-GN) (serum/urine: 13/11 cases).

Results

In pretreatment s- and u-suPAR, no significant differences were observed between the primary NS and ANCA-GN groups or among the pathological types of primary NS. An inverse correlation was noted between pretreatment s-suPAR and eGFR in the primary NS and ANCA-GN groups. A positive correlation was noted between pretreatment u-suPAR and proteinuria in the primary NS group. Furthermore, time-course changes in s- and u-suPAR over 2 months after therapy were associated with the therapeutic responsiveness of primary NS, particularly the differentiation of MCNS from FSGS (s-suPAR: AUC-ROC = 0.905, p = 0.007; u-suPAR: AUC-ROC = 0.816, p = 0.048). In the ANCA-GN group, a positive correlation was found between pretreatment s-suPAR and clinical severity or crescent formation, whereas u-suPAR was not correlated with these parameters.

Conclusion

S- and u-suPAR after therapy may serve as clinical markers to judge the treatment response of untreated NS and differentiate MCNS from FSGS, but not in pretreatment patients. S-, but not u-suPAR may predict the severity of and crescent formation in ANCA-GN.

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Acknowledgments

The authors gratefully acknowledge the help and assistance of their colleagues at the Division of Nephrology. This study was supported, in part, by a Grant-in-Aid for Progressive Renal Disease Research from the Ministry of Health, Labour, and Welfare of Japan and a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (HY, (C) No. 25461237; (B) No. 24406029, No. 25305028).

Conflict of interest

None of the authors have any conflicts of interest to disclose regarding this paper.

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Authors and Affiliations

  1. Division of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan

    Keiji Fujimoto, Junko Imura, Hirokatsu Atsumi, Yuki Matsui, Hiroki Adachi, Hiroshi Okuyama, Hideki Yamaya & Hitoshi Yokoyama

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  1. Keiji Fujimoto
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  2. Junko Imura
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  3. Hirokatsu Atsumi
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  4. Yuki Matsui
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  5. Hiroki Adachi
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  6. Hiroshi Okuyama
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  7. Hideki Yamaya
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  8. Hitoshi Yokoyama
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Correspondence to Hitoshi Yokoyama.

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Fujimoto, K., Imura, J., Atsumi, H. et al. Clinical significance of serum and urinary soluble urokinase receptor (suPAR) in primary nephrotic syndrome and MPO-ANCA-associated glomerulonephritis in Japanese. Clin Exp Nephrol 19, 804–814 (2015). https://doi.org/10.1007/s10157-014-1067-x

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  • DOI: https://doi.org/10.1007/s10157-014-1067-x

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