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

Fujimoto, Keiji; Imura, Junko; Atsumi, Hirokatsu; Matsui, Yoshihiko; Adachi, Hisashi; Okuyama, Hiroshi; Yamaya, Hideki; Yokoyama, Hitoshi

doi:10.1007/s10157-014-1067-x

Cited by 13 publications

(14 citation statements)

References 17 publications

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“…Similar to Fujimoto et al's results [25], we also detected that the suPAR levels positively correlated with CRP and inversely correlated with eGFR levels. In addition, we demonstrated that there is an association between the concentration of suPAR with other clinical parameters in AAV, including BVAS, PCT, and C3, further revealing a close relationship between suPAR levels and disease activity.…”

Section: Discussionsupporting

confidence: 92%

“…A recent study indicated independent associations between increased plasma suPAR levels and incident chronic kidney diseases (CKD) [24]. Fujimoto et al [25] reported significant higher suPAR levels in 13 patients with MPO-ANCAassociated glomerulonephritis (ANCA-GN) and indicated that these levels might be a useful marker to assess clinical severity of ANCA-GN. Meanwhile, the role of suPAR in AAV is unclear.…”

Section: Introductionmentioning

confidence: 99%

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The Plasma Soluble Urokinase Plasminogen Activator Receptor Is Related to Disease Activity of Patients with ANCA-Associated Vasculitis

Huang

et al. 2020

Mediators of Inflammation

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Objective. The soluble urokinase plasminogen activator receptor (suPAR) is associated with kidney diseases and is used as a prognostic factor of renal function progression. The aim of this study was to explore whether circulating suPAR was associated with antineutrophil cytoplasmic autoantibody- (ANCA-) associated vasculitis (AAV) disease activity. Methods. We evaluated 90 AAV patients with follow-up data and 35 normal controls; their plasma suPAR and C-reactive protein (CRP) levels were measured by ELISA. Associations between these levels, clinical parameters, and prognosis were analyzed. Results. Plasma suPAR levels in AAV patients were significantly higher than in healthy controls (5,920.08±3,447.17 vs. 1,441.97±835.04 pg/mL, P<0.001). Furthermore, suPAR was significantly elevated in AAV patients in active stage compared to those in partial remissions (6,492.19±3,689.48 vs. 5,031.86±2,489.01 pg/mL, P=0.039). Correlation analyses demonstrated that suPAR levels positively correlated with initial serum creatinine, BVAS, CRP, and procalcitonin concentration, and negatively correlated with eGFR and C3 circulating levels. In a Kaplan-Meier survival analysis, patients with plasma suPAR levels >5683.3 pg/mL showed poorer survival than patients with lower levels (log-rank, P=0.001). Besides, multivariate analyses confirmed that plasma suPAR levels were an independent adverse prognostic factor for a composite outcome of end-stage renal disease (ESRD) or death, after adjusting for age and gender (HR 1.05, 95% CI=1.01−1.11, P=0.043). Receiver operating characteristic curves showed a suPAR cutoff value >6662.2 pg/mL for composite outcome with 68% sensitivity and 88% specificity, with an AUC=0.82, (95% CI=0.68−0.96, P<0.001). Conclusion. Circulating suPAR levels might be a marker of activity correlated with disease activity in AAV patients, and, to some extent, could be a factor of poor prognosis.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The Plasma Soluble Urokinase Plasminogen Activator Receptor Is Related to Disease Activity of Patients with ANCA-Associated Vasculitis

Huang

et al. 2020

Mediators of Inflammation

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“…Thus, 364 studies were initially included, among which 306 studies were excluded after reading the title and abstract. After reading the full text, another 29 studies were excluded; therefore, 29 studies were finally included 9–11 21–46. A flow chart of the study selection process is presented in figure 1.…”

Section: Resultsmentioning

confidence: 99%

Serum soluble urokinase type plasminogen activated receptor and focal segmental glomerulosclerosis: a systematic review and meta-analysis

et al. 2019

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ObjectivesSoluble urokinase plasminogen activated receptor (suPAR) is a biomarker that may predict the occurrence of focal segmental glomerulosclerosis (FSGS); however, there is still controversy about whether suPAR can predict FSGS. In this study, we performed a systematic evaluation and meta-analysis to prove whether suPAR can predict FSGS, and to detect a threshold concentration of suPAR that can be used to diagnose FSGS. In addition, a threshold concentration of suPAR for the diagnosis of FSGS was proposed.DesignSystematic review and meta-analysis.Data sourcesWe systematically searched PubMed, Embase, Cochrane Library, Web of Science and China Biology Medicine databases for studies published from the inception dates to 1 December 2018.Eligibility criteria(1) Data involving the suPAR level were from blood samples; (2) FSGS was diagnosed by biopsy; and (3) randomised controlled trials, cohort studies, case–control studies and cross-sectional studies.Data extraction and synthesisInitially, a total of 364 studies were searched, among which 29 studies were finally included. In addition, seven studies described the cut-off value of suPAR, which ranged from 2992.6 to 5500 pg/mL.ResultsThe results showed that the suPAR levels in the primary FSGS group were significantly higher when compared with that in the normal control group (p<0.001; standard mean difference (SMD): 2.56; 95% CI 1.85 to 3.28), and significant differences were observed in the secondary FSGS and in the normal control group (p<0.001; SMD: 1.68; 95% CI 1.37 to 1.98). A suPAR concentration of 3000 pg/mL may be the best threshold for the diagnosis of primary FSGS (sensitivity=0.72; specificity=0.88; area under the curve=0.85).ConclusionOur results suggested that suPAR might be a potential biomarker for predicting primary and secondary FSGS. In addition, our data showed that a suPAR concentration of 3000 pg/mL might be used as a threshold for the diagnosis of FSGS.Trial registration numberCRD42019120948.

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“…In addition, the patients with hypocomplementemia had high urine protein levels (2.24 g/gCr). Fujimoto et al [23] reported that 13 patients with MPO-ANCA-associated glomerulonephritis had 1.2 (0.6–2.0) g/gCr (median interquartile range]) of urine protein. This result may support our hypothesis that immune complexes have an important role in the pathogenesis of AAV with hypocomplementemia.…”

Section: Discussionmentioning

confidence: 99%

Antineutrophilic cytoplasmic antibody-associated vasculitis with hypocomplementemia has a higher incidence of serious organ damage and a poor prognosis

Fukui¹,

Iwamoto²,

Umeda³

et al. 2016

Medicine

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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

Abstract: 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.

Cited by 13 publications

References 17 publications

The Plasma Soluble Urokinase Plasminogen Activator Receptor Is Related to Disease Activity of Patients with ANCA-Associated Vasculitis

The Plasma Soluble Urokinase Plasminogen Activator Receptor Is Related to Disease Activity of Patients with ANCA-Associated Vasculitis

Serum soluble urokinase type plasminogen activated receptor and focal segmental glomerulosclerosis: a systematic review and meta-analysis

Antineutrophilic cytoplasmic antibody-associated vasculitis with hypocomplementemia has a higher incidence of serious organ damage and a poor prognosis

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