Plasma Soluble Urokinase Receptor Level Is Correlated with Podocytes Damage in Patients with IgA Nephropathy.
Plasma Soluble Urokinase Receptor Level Is Correlated with Podocytes Damage in Patients with IgA Nephropathy.
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IgA 肾病患者血浆可溶性尿激酶受体水平与足细胞损伤相关
DOI：
10.1371/journal.pone.0132869
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Zhang H
中科院分区：
文献类型：
--
作者：
Zhao Y;Liu L;Huang J;Shi S;Lv J;Liu G;Zhao M;Zhang H
背景局灶节段性肾小球硬化（FSGS）病变的特征与伊加肾病牛津分类（IgAN）中的S病变相似，可能预示预后不良。在本研究中，我们的目的是探讨血浆可溶性尿激酶受体（suPAR）水平与IgA肾病患者的S病变和足细胞损伤之间的关系。方法收集569例有随访资料的IgAN患者，采用酶联免疫吸附试验（ELISA）检测其肾活检标本中suPAR水平。结果IgAN伴或不伴S病变患者血浆suPAR水平差异无统计学意义（P = 0.411）。suPAR水平与蛋白尿呈正相关（r = 0.202，P < 0.001），与肾小球滤过率（eGFR，r =-0.236，P < 0.001）呈负相关。在校正eGFR的偏相关中，血浆suPAR水平与蛋白尿呈正相关（r = 0.112，P = 0.023）。在考克斯比例风险模型中，较高水平的血浆suPAR与肾脏预后不良无关。IgAN与原发性FSGS肾病综合征患者血浆suPAR水平无显著性差异（P = 0.306）。肾小球足细胞的上皮细胞足突广泛消失的患者血浆suPAR水平显著高于节段性消失的患者（P = 0.036）。结论IgAN患者血浆suPAR水平与S病变无关。然而，它们与蛋白尿呈正相关，与eGFR呈负相关。此外，血浆suPAR水平与足突的消退程度呈正相关，这可能是IgAN患者蛋白尿发生的部分原因。
Background Focal segmental glomerulosclerosis (FSGS) lesions are similar in characteristics to S lesions of the Oxford classification of IgA nephropathy (IgAN) and may predict poor prognosis. In the present study, we aimed to explore the association between plasma soluble urokinase receptor (suPAR) levels and S lesions and podocytes damage in IgAN patients. Methods We enrolled 569 IgAN patients with follow-up data and detected plasma suPAR levels at renal biopsy by enzyme-linked immunosorbent assay. Results Plasma suPAR levels in IgAN patients with or without S lesions did not differ significantly (P = 0.411). However, suPAR levels were positively correlated with proteinuria (r = 0.202, P < 0.001), and negatively correlated with estimated glomerular filtration rate (eGFR, r = –0.236, P < 0.001). In the partial correlation to adjust for eGFR, plasma suPAR levels remained positively correlated with proteinuria (r = 0.112, P = 0.023). In a Cox proportional hazards model, higher levels of plasma suPAR were not associated with poor renal outcome. Plasma suPAR levels of IgAN and primary FSGS patients with nephrotic syndrome were not significantly different (P = 0.306). Plasma suPAR levels in patients with extensive effacement of the epithelial cell foot processes of glomerular podocytes were significantly higher than those with segmental effacement on the basis of comparable eGFR (P = 0.036). Conclusions In IgAN patients, plasma suPAR levels were not associated with S lesions. However, they were positively associated with proteinuria and negatively associated with eGFR. In addition, plasma suPAR levels were positively associated with the effacement degree of the foot processes, which might partially contribute to the development of proteinuria in patients with IgAN.