Association between Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Shuai, Tiankui; Yan, Peijing; Xiong, Huaiyu; Huang, Qiangru; Zhu, Lei; Yang, Kehu; Liu, Jian

doi:10.1155/2019/6927456

Cited by 8 publications

(4 citation statements)

References 51 publications

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“…In the kidney, suPAR can induce podocyte dysfunction and impair glomerular filtration function thus leading to the development of CKD ( Hayek et al, 2015 ; Lv et al, 2020 ), a phenomenon mostly found in focal segmental glomerulosclerosis studies ( Wei et al, 2011 ). 2019 a meta-analysis of the relationship between suPAR and kidney disease pointed out that suPAR was negatively correlated with eGFR, and in patients with CKD, especially ESRD patients suPAR levels were significantly higher than normal ( Shuai et al, 2019 ). Several subsequent studies suggested that close monitoring of suPAR could help in the early diagnosis and treatment of CKD and that suPAR levels were associated with CKD prognosis ( Rotbain Curovic et al, 2019 ; Shuai et al, 2019 ).…”

Section: Abnormalities Of Biomarkers In Dialysis Patientsmentioning

confidence: 99%

“…2019 a meta-analysis of the relationship between suPAR and kidney disease pointed out that suPAR was negatively correlated with eGFR, and in patients with CKD, especially ESRD patients suPAR levels were significantly higher than normal ( Shuai et al, 2019 ). Several subsequent studies suggested that close monitoring of suPAR could help in the early diagnosis and treatment of CKD and that suPAR levels were associated with CKD prognosis ( Rotbain Curovic et al, 2019 ; Shuai et al, 2019 ). 2021 Jhee et al evaluated the relationship between disease progression and suPAR in 751 CKD patients and demonstrated that suPAR levels were also independently associated with CKD progression ( Jhee et al, 2021 ).…”

Section: Abnormalities Of Biomarkers In Dialysis Patientsmentioning

confidence: 99%

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Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Wang

Gao

2022

Front. Pharmacol.

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Chronic kidney disease (CKD) and cardiac insufficiency often co-exist, particularly in uremic patients on hemodialysis (HD). The occurrence of abnormal renal function in patients with cardiac insufficiency is often indicative of a poor prognosis. It has long been established that in patients with cardiac insufficiency, poorer renal function tends to indicate poorer cardiac mechanics, including left atrial reserve strain, left ventricular longitudinal strain, and right ventricular free wall strain (Unger et al., Eur J Heart Fail, 2016, 18(1), 103–12). Similarly, patients with chronic kidney disease, particularly uremic patients on HD, often have cardiovascular complications in addition to abnormal endothelial function with volume overload, persistent inflammatory states, calcium overload, and imbalances in redox responses. Cardiac insufficiency due to uremia is therefore mainly due to multifaceted non-specific pathological changes rather than pure renal insufficiency. Several studies have shown that the risk of adverse cardiovascular events is greatly increased and persistent in all patients treated with HD, especially in those who have just started HD treatment. Inflammation, as an important intersection between CKD and cardiovascular disease, is involved in the development of cardiovascular complications in patients with CKD and is indicative of prognosis (Chan et al., Eur Heart J, 2021, 42(13), 1244–1253). Therefore, only by understanding the mechanisms underlying the sequential development of inflammation in CKD patients and breaking the vicious circle between inflammation-mediated renal and cardiac insufficiency is it possible to improve the prognosis of patients with end-stage renal disease (ESRD). This review highlights the mechanisms of inflammation and the oxidative stress that co-exists with inflammation in uremic patients on dialysis, as well as the mechanisms of cardiovascular complications in the inflammatory state, and provides clinical recommendations for the anti-inflammatory treatment of cardiovascular complications in such patients.

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Section: Abnormalities Of Biomarkers In Dialysis Patientsmentioning

confidence: 99%

Section: Abnormalities Of Biomarkers In Dialysis Patientsmentioning

confidence: 99%

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Wang

Gao

2022

Front. Pharmacol.

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“…A meta-analysis of patients with chronic kidney disease showed that in this patient population, elevated suPAR levels are also predictive of increased risk of cardiovascular disease (p < 0.001; HR: 3.06; 95% CI: 2.21-4.22; I 2 = = 0.0%). This prediction makes it possible, similarly to the population of patients with diabetes, to intensify the treatment and isolate the population requiring in-depth cardiological diagnostics [47].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of soluble urokinase‐type plasminogen activator receptor in patients with acute coronary syndrome: A systematic review and meta-analysis

Pruc,

Jannasz,

Swieczkowski

et al. 2023

Cardiol J.

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Background: In contemporary clinical practice, there is an increasing need for new clinically relevant biomarkers potentially optimizing management strategies in patients with suspected acute coronary syndrome (ACS). This study aimed to determine the diagnostic utility of soluble urokinase-type plasminogen activator receptor (suPAR) levels in individuals with suspected ACS. Methods: A literature search was performed in Web of Science, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials databases, for studies comparing suPAR levels among patients with and without ACS groups. The methodological quality of the included papers was assessed using the Newcastle-Ottawa Scale. A fixed-effects model was used if I 2 < 50%; otherwise, the random-effects model was performed. Results: Five studies with 3417 participants were included in the meta-analysis. Pooled analysis showed that mean suPAR levels in the ACS group were statistically significantly higher than in the control group (3.56 ± 1.38 vs. 2.78 ± 0.54 ng/mL, respectively; mean difference: 1.04; 95% confidence interval: 0.64-1.44; I 2 = 99%; p < 0.001). Conclusions: In the context of ACS, suPAR is a potential biomarker for the early identification of medical conditions in individuals who are being treated in emergency rooms.

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“…A meta-analysis revealed that suPAR levels may serve as a prognostic biomarker in CKD patients. The higher suPAR level has been shown to increase the risk of mortality, cardiovascular accidents, and ESRD occurrence [119].…”

Section: Supar Levels and Ckdmentioning

confidence: 99%

The Perspective of Vitamin D on suPAR-Related AKI in COVID-19

Liao

et al. 2022

IJMS

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The coronavirus disease 2019 (COVID-19) pandemic has claimed the lives of millions of people around the world. Severe vitamin D deficiency can increase the risk of death in people with COVID-19. There is growing evidence that acute kidney injury (AKI) is common in COVID-19 patients and is associated with poorer clinical outcomes. The kidney effects of SARS-CoV-2 are directly mediated by angiotensin 2-converting enzyme (ACE2) receptors. AKI is also caused by indirect causes such as the hypercoagulable state and microvascular thrombosis. The increased release of soluble urokinase-type plasminogen activator receptor (suPAR) from immature myeloid cells reduces plasminogen activation by the competitive inhibition of urokinase-type plasminogen activator, which results in low plasmin levels and a fibrinolytic state in COVID-19. Frequent hypercoagulability in critically ill patients with COVID-19 may exacerbate the severity of thrombosis. Versican expression in proximal tubular cells leads to the proliferation of interstitial fibroblasts through the C3a and suPAR pathways. Vitamin D attenuates the local expression of podocyte uPAR and decreases elevated circulating suPAR levels caused by systemic inflammation. This decrease preserves the function and structure of the glomerular barrier, thereby maintaining renal function. The attenuated hyperinflammatory state reduces complement activation, resulting in lower serum C3a levels. Vitamin D can also protect against COVID-19 by modulating innate and adaptive immunity, increasing ACE2 expression, and inhibiting the renin–angiotensin–aldosterone system. We hypothesized that by reducing suPAR levels, appropriate vitamin D supplementation could prevent the progression and reduce the severity of AKI in COVID-19 patients, although the data available require further elucidation.

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Association between Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 51 publications

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Inflammation and Cardiovascular Disease Associated With Hemodialysis for End-Stage Renal Disease

Diagnostic value of soluble urokinase‐type plasminogen activator receptor in patients with acute coronary syndrome: A systematic review and meta-analysis

The Perspective of Vitamin D on suPAR-Related AKI in COVID-19

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