Profiling proteinuria in pediatric patients

Abitbol, Carolyn; Chandar, Jayanthi; Onder, Ali Mirza; Nwobi, Obioma; Montané, Brenda; Zilleruelo, Gastón

doi:10.1007/s00467-006-0103-9

Cited by 31 publications

(33 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients were classified as having nephrotic-range proteinuria if U-Pr/Cr at time of suPAR sample collection was .2 (11,12). Patients were grouped into four cohorts: FSGS and non-FSGS glomerular disease based on kidney biopsy findings, nonglomerular kidney disease based on clinical diagnosis (hypoplasia/dysplasia, obstructive uropathy, or cortical necrosis), or healthy controls.…”

Section: Methodsmentioning

confidence: 99%

Serum Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Idiopathic FSGS in Children

Bock

Price

Gallon

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives FSGS is the primary cause of childhood nephrotic syndrome leading to ESRD. Permeability factors, including circulating serum soluble urokinase-type plasminogen activator receptor (suPAR), have been postulated as putative causes in adults with primary FSGS. Similar results have yet to be proven in children.Design, setting, participants, & measurements This cross-sectional single-center study assessed the association of serum suPAR in children with FSGS or other glomerular and nonglomerular kidney diseases.Results This study examined 110 samples retrieved from 99 individuals (between January 2011 and April 2012), aged 1-21 years; of these individuals, 20 had primary FSGS, 24 had non-FSGS glomerular disease, 26 had nonglomerular kidney disease, and 29 were healthy controls. suPAR levels were not significantly different in children with FSGS, non-FSGS glomerular disease, and healthy controls (P.0.05). However, suPAR levels (median [25%-75%]) were higher in children with nonglomerular kidney disease (3385 pg/ml ) versus FSGS (2487 pg/ml [2191-3351]; P,0.05). Female patients with nephrotic-range proteinuria (U-Pr/Cr .2) had lower suPAR levels than those without proteinuria (2380 pg/ml versus 3125 pg/ml , respectively; P,0.001). This trend was not seen among male participants; suPAR levels in all female participants were lower than in male participants (P=0.03). Thirty-four patients studied were kidney transplant recipients; transplant status was not associated with suPAR levels in patients with FSGS or non-FSGS diagnoses, independent of proteinuria, race, or sex (P.0.05).Conclusions On the basis of these results, circulating suPAR is unlikely the leading cause for childhood idiopathic FSGS.

show abstract

Section: Methodsmentioning

confidence: 99%

Serum Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Idiopathic FSGS in Children

Bock

Price

Gallon

et al. 2013

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…Degree of proteinuria was determined by the random urine protein to creatinine ratio (UPr/Cr, in mg/mg) with normal (Ͻ0.2) and nephrotic (Ͼ1.0) range (22). By protocol, the first morning void was attempted but was not consistently available.…”

Section: Ln and Renal Disease Activitymentioning

confidence: 99%

Three Decades of Progress in Treating Childhood-Onset Lupus Nephritis

Pereira¹,

Abitbol²,

Seeherunvong³

et al. 2011

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our observations show a distinct advantage with dual therapy in maximizing the lowering of the albumin component of proteinuria. This difference would not have been perceived without differentiating the proteinuria into the albumin and 'non-albumin' fractions [24]. Because angiotensin II is also generated from angiotensin I by enzymes other than ACE, ARB would provide a more effective blockade of angiotensin II; however, ACE inhibition increases plasma levels of substances such as bradykinin which have strong antifibrotic properties.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin blockade as sole treatment for proteinuric kidney disease in children

Chandar

Abitbol

Montané

et al. 2007

Nephrology Dialysis Transplantation

View full text Add to dashboard Cite

Background. The traditional management of children with proteinuric kidney disease is treatment with high dose steroids regardless of comorbid conditions such as obesity. This study evaluated the effect of angiotensin blockade (AB) alone as the sole management of children with non-diabetic proteinuric kidney disease. Methods. Retrospective chart analysis was performed in 146 children. Seventeen were identified to have received angiotensin-converting enzyme inhibitor and/ or angiotensin receptor blocker exclusively for management of proteinuria. Total proteinuria (Upr/cr), albuminuria (Ualb/cr), estimated glomerular filtration rate (eGFR), serum potassium and blood pressure were assessed at baseline and at 3-month intervals for over 24 months. Results. Mean age was 11.2 AE 4.8 years with 12 females. Eleven of 17 patients (65%) were overweight or obese. There was a significant decline in total proteinuria and albuminuria after 3-6 months of AB therapy and a further decline with longer duration of treatment (P < 0.001). Although single vs dual AB were similarly effective in lowering total proteinuria, dual therapy was more effective in lowering albuminuria (single 57 AE 23% vs dual 71 AE 15%; P < 0.02). The eGFR decreased from 'hyperfiltration' levels prior to initiation of AB to normal at the end of the treatment period (145 AE 41-111 AE 17 ml/min/1.73m 2 ; P ¼ 0.01). Systemic blood pressures remained normal throughout the study period. Conclusions. Angiotensin blockade alone appears to effectively control proteinuria and stabilize kidney function in children. This may provide an alternative to more toxic therapies, especially corticosteroids, in children with glomerular disorders such as those associated with obesity.

show abstract

Profiling proteinuria in pediatric patients

Cited by 31 publications

References 31 publications

Serum Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Idiopathic FSGS in Children

Serum Soluble Urokinase-Type Plasminogen Activator Receptor Levels and Idiopathic FSGS in Children

Three Decades of Progress in Treating Childhood-Onset Lupus Nephritis

Angiotensin blockade as sole treatment for proteinuric kidney disease in children

Contact Info

Product

Resources

About