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Urinary uromodulin excretion predicts progression of chronic kidney disease resulting from IgA nephropathy.

Zhou J, Chen Y, Liu Y, Shi S, Wang S, Li X, Zhang H, Wang H - PLoS ONE (2013)

Bottom Line: We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort.Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.

ABSTRACT

Background: Uromodulin, or Tamm-Horsfall protein, is the most abundant urinary protein in healthy individuals. Recent studies have suggested that uromodulin may play a role in chronic kidney diseases. We examined an IgA nephropathy cohort to determine whether uromodulin plays a role in the progression of IgA nephropathy.

Methods: A total of 344 IgA nephropathy patients were involved in this study. Morphological changes were evaluated with the Oxford classification of IgA nephropathy. Enzyme Linked Immunosorbent Assay (ELISA) measured the urinary uromodulin level on the renal biopsy day. Follow up was done regularly on 185 patients. Time-average blood pressure, time-average proteinuria, estimated glomerular filtration rate (eGFR) and eGFR decline rate were caculated. Association between the urinary uromodulin level and the eGFR decline rate was analyzed with SPSS 13.0.

Results: We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort. Urinary uromodulin level was correlated with tubulointerstitial lesions (P = 0.016). Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).

Conclusions: Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.

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Urinary uromoudulin levels association with gender.Median urinary uromodulin level is presented (inter-quartile range [IQR]). Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels between the two groups.
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pone-0071023-g002: Urinary uromoudulin levels association with gender.Median urinary uromodulin level is presented (inter-quartile range [IQR]). Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels between the two groups.

Mentions: In the linear regression analysis, urinary uromodulin levels were selected as the dependent variable, and physical/biochemical factors such as age, gender, baseline-eGFR, baseline-proteinuria, SBP, DBP and pathological items (M/E/S/T) were analyzed with single factor and then multiple factors models. Using the multiple factors model, we found that gender (P = 0.032) and tubular atrophy/interstitial fibrosis (P = 0.016) were associated with urinary uromodulin levels (Table 4). Patients with more tubular atrophy and interstitial fibrosis had lower concentrations of urinary uromodulin (P = 0.016, Table 4 & Figure 1), and the urinary uromodulin level in females was higher than that in males (P = 0.036, Table 4 & Figure 2). Other clinical/pathological parameters, such as baseline eGFR, proteinuria, blood pressure, mesangial hypercellularity, endocapillary hypercellularity and segmental glomerulosclerosis, did not correlate with urinary uromodulin levels.


Urinary uromodulin excretion predicts progression of chronic kidney disease resulting from IgA nephropathy.

Zhou J, Chen Y, Liu Y, Shi S, Wang S, Li X, Zhang H, Wang H - PLoS ONE (2013)

Urinary uromoudulin levels association with gender.Median urinary uromodulin level is presented (inter-quartile range [IQR]). Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels between the two groups.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3750049&req=5

pone-0071023-g002: Urinary uromoudulin levels association with gender.Median urinary uromodulin level is presented (inter-quartile range [IQR]). Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels between the two groups.
Mentions: In the linear regression analysis, urinary uromodulin levels were selected as the dependent variable, and physical/biochemical factors such as age, gender, baseline-eGFR, baseline-proteinuria, SBP, DBP and pathological items (M/E/S/T) were analyzed with single factor and then multiple factors models. Using the multiple factors model, we found that gender (P = 0.032) and tubular atrophy/interstitial fibrosis (P = 0.016) were associated with urinary uromodulin levels (Table 4). Patients with more tubular atrophy and interstitial fibrosis had lower concentrations of urinary uromodulin (P = 0.016, Table 4 & Figure 1), and the urinary uromodulin level in females was higher than that in males (P = 0.036, Table 4 & Figure 2). Other clinical/pathological parameters, such as baseline eGFR, proteinuria, blood pressure, mesangial hypercellularity, endocapillary hypercellularity and segmental glomerulosclerosis, did not correlate with urinary uromodulin levels.

Bottom Line: We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort.Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.

ABSTRACT

Background: Uromodulin, or Tamm-Horsfall protein, is the most abundant urinary protein in healthy individuals. Recent studies have suggested that uromodulin may play a role in chronic kidney diseases. We examined an IgA nephropathy cohort to determine whether uromodulin plays a role in the progression of IgA nephropathy.

Methods: A total of 344 IgA nephropathy patients were involved in this study. Morphological changes were evaluated with the Oxford classification of IgA nephropathy. Enzyme Linked Immunosorbent Assay (ELISA) measured the urinary uromodulin level on the renal biopsy day. Follow up was done regularly on 185 patients. Time-average blood pressure, time-average proteinuria, estimated glomerular filtration rate (eGFR) and eGFR decline rate were caculated. Association between the urinary uromodulin level and the eGFR decline rate was analyzed with SPSS 13.0.

Results: We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort. Urinary uromodulin level was correlated with tubulointerstitial lesions (P = 0.016). Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).

Conclusions: Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.

Show MeSH
Related in: MedlinePlus