Detection of urinary podocytes and nephrin as markers for children with glomerular diseases

Abstract

The purpose of this study was to detect the urinary podocytes and its related protein, nephrin, in the urine of the children with glomerular disease in order to analyze the relationship of the clinical testing with the significance of the glomerular disease. A total of 65 children with nephrotic syndrome were selected for this study. The podocytes and nephrin were detected in the urinary sediment by indirect immunofluorescence, enzyme-linked immunosorbent assay, and Western blotting. The urinary podocytes and nephrin positive rates were 53.8% and 50.8%, respectively, in the children with glomerular disease. The serum total protein and albumin decreased in the podocyte-positive children, while the urine total protein at 24 h, urinary albumin/creatinine ratio, blood urea nitrogen, and serum creatinine were significantly elevated as compared to those of the podocyte-negative patients. Furthermore, the results were the same in the patients with positive nephrin as compared to that of the patients with negative nephrin. The podocyte number and nephrin level were significantly higher in the lupus nephritis group as compared to those of the other groups. Likewise, the podocyte number and nephrin level dramatically increased in the focal segmental glomerulosclerosis group as compared to those of the mesangial proliferative glomerulonephritis and minimal change disease groups. In addition, the podocyte numbers and nephrin expression were significantly higher in severe proteinuria group as compared to those of the mild proteinuria group. The urinary nephrin expression was positively related to podocyte and urinary albumin/creatinine ratio. We concluded that the detection of the urinary podocytes and nephrin could be taken as markers for children with glomerular disease, reflecting the type of the disease. Therefore, this can be used as a noninvasive method to evaluate the severity of the kidney disease in children.

mTOR-mediated podocyte hypertrophy regulates glomerular integrity in mice and humans

“…This raises an important issue: how can physicians determine if active podocyte loss is taking place in their patients? While a definitive answer is not available, an interesting alternative may be found in the analysis of urinary markers of podocyte loss (32)(33)(34). However, we believe there is a growing need for the development of noninvasive methods to assess podocyte loss.…”

Urinary Nephrin as a Biomarker of Glomerular Maturation and Injury Is Associated with Acute Kidney Injury and Mortality in Critically Ill Neonates

“…Nephrin exists in podocytes and enters the urine in response to podocyte injury [11, 14-17]. The significantly higher concentration of uNep in AKI neonates demonstrates the presence of podocyte injury in neonates with AKI.…”

“…The protein markers in podocytes can be excreted in urine in the presence of podocyte injury, and the increased concentrations of nephrin in urine may reflect early glomerular injury [11-13]. To date, most studies of urinary nephrin (uNep) have been conducted in patients who have kidney disease with podocyte dysfunction, such as lupus nephritis, and have investigated the association of uNep with various renal traits [14-17]. The clinical utility of uNep for the detection of AKI in patients has not been evaluated.…”

Screening for potential serum biomarkers in rat mesangial proliferative nephritis

“…Several studies have explored biomarkers in serum and urine for MesPGN. It was reported that podocytes and nephrin in the urinary sediment and urinary transferrin were useful markers in children with glomerular disease . Kalantari et al.…”

“…Several studies have explored biomarkers in serum and urine for MesPGN. It was reported that podocytes and nephrin in the urinary sediment and urinary transferrin were useful markers in children with glomerular disease [2,3]. Kalantari et al found that differentially excreted candidate urinary proteins had potential as prognostic biomarkers for IgA nephritis [4].…”