ORIGINAL ARTICLE   

Minerva Pediatrica 2019 February;71(1):4-11

DOI: 10.23736/S0026-4946.16.04461-3

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Circulating suPAR as a biomarker of disease severity in children with proteinuric glomerulonephritis

Jolanta SOŁTYSIAK ¹ ✉, Jacek ZACHWIEJA ¹, Anna BENEDYK ¹, Maria LEWANDOWSKA-STACHOWIAK ¹, Michal NOWICKI ², Danuta OSTALSKA-NOWICKA ¹

¹ Department of Pediatric Nephrology and Cardiology, Poznan University of Medical Sciences, Poznan, Poland; ² Department of Histology and Embryology, Poznan University of Medical Sciences, Poznan, Poland

BACKGROUND: The increase of circulating urokinase plasminogen activator receptor (suPAR) was demonstrated in various diseases showing its prognostic value as well as the link to the inflammatory reaction. In glomerular diseases, suPAR was considered a causative factor of proteinuria. In the present study we aimed to evaluate serum concentration of suPAR in children with primary and secondary glomerulonephritis (GN) and its association with disease severity.
METHODS: The study involved 22 children with minimal change disease (MCD), nine with primary focal segmental glomerulosclerosis (FSGS), seven with Henoch-Schönlein nephritis, seven with lupus nephritis (LN) and 16 controls.
RESULTS: Serum suPAR was significantly higher in children with FSGS and LN than controls (4.47±1.39 ng/mL vs. 3.23±0.76 ng/mL; P=0.011 and 6.17±1.12 ng/mL vs. 3.23±0.76 ng/mL, respectively; P<0.0001). Further, suPAR was increased in LN when compared to FSGS (P=0.031). In the total group suPAR showed negative correlation with eGFR, serum complement C3 and positive with left ventricular mass index. In children with MCD and FSGS the inverse association of suPAR with eGFR was also shown.
CONCLUSIONS: In children with primary and secondary glomerulonephritis suPAR levels are not associated with proteinuria. In primary GN elevated suPAR levels may result from reduced eGFR reflecting renal damage. In LN circulating suPAR can be increased further indicating both multi-organ involvement and systemic inflammation reflecting disease severity.

KEY WORDS: Focal segmental glomerulosclerosis - Lupus nephritis - Glomerular filtration rate