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Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study

This retrospective exploratory study aimed to identify early clinical indicators of kidney prognosis in primary nephrotic syndrome (NS). Univariate Cox proportional hazards regression analysis identified clinical parameters in the 2-month period after initiating immunosuppressive therapy (IST); it p...

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Autores principales: Fujimoto, Keiji, Haraguchi, Takatoshi, Kumano, Sho, Yamazaki, Keita, Miyatake, Nobuhiko, Nomura, Kanae, Mukai, Kiyotaka, Okino, Kazuaki, Hayashi, Norifumi, Adachi, Hiroki, Yokoyama, Hitoshi, Iida, Yasuo, Furuichi, Kengo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381284/
https://www.ncbi.nlm.nih.gov/pubmed/35983504
http://dx.doi.org/10.1155/2022/2718810
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author Fujimoto, Keiji
Haraguchi, Takatoshi
Kumano, Sho
Yamazaki, Keita
Miyatake, Nobuhiko
Nomura, Kanae
Mukai, Kiyotaka
Okino, Kazuaki
Hayashi, Norifumi
Adachi, Hiroki
Yokoyama, Hitoshi
Iida, Yasuo
Furuichi, Kengo
author_facet Fujimoto, Keiji
Haraguchi, Takatoshi
Kumano, Sho
Yamazaki, Keita
Miyatake, Nobuhiko
Nomura, Kanae
Mukai, Kiyotaka
Okino, Kazuaki
Hayashi, Norifumi
Adachi, Hiroki
Yokoyama, Hitoshi
Iida, Yasuo
Furuichi, Kengo
author_sort Fujimoto, Keiji
collection PubMed
description This retrospective exploratory study aimed to identify early clinical indicators of kidney prognosis in primary nephrotic syndrome (NS). Univariate Cox proportional hazards regression analysis identified clinical parameters in the 2-month period after initiating immunosuppressive therapy (IST); it predicted 40% reduction in the estimated glomerular filtration rate (eGFR) in 36 patients with primary NS. Time-dependent receiver operating characteristic curve analysis was used to evaluate the performance of the predictors for the cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST. The mean follow-up period was 71.9 months. The eGFR was reduced by 40% in four patients. Significant predictors for time to 40% reduction in the eGFR were as follows: an increase in the serum soluble urokinase plasminogen activator receptor (s-suPAR) 2 months after initiating IST (Δs-suPAR (2M); hazard ratio (HR) for every 500 pg/mL increase: 1.36, P=0.006), s-suPAR at 2 months after initiating IST (s-suPAR (2M); HR for every 500 pg/mL increase: 1.13, P=0.015), urinary protein-to-creatinine ratio (u-PCR) (u-PCR (2M); HR for every 1.0 g/gCr increase: 2.94, P=0.003), and urinary liver-type fatty acid-binding protein (u-L-FABP) (u-L-FABP (2M); HR for every 1.0 μg/gCr increase: 1.14, P=0.006). All four factors exhibited high predictive accuracy for cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST, with areas under the receiver operating characteristic curve of 0.92 for Δs-suPAR (2M), 0.87 for s-suPAR (2M), 0.93 for u-PCR (2M), and 0.93 for u-L-FABP (2M). These findings suggest that Δs-suPAR (2M), s-suPAR (2M), u-PCR (2M), and u-L-FABP (2M) could be useful indicators of initial therapeutic response for predicting kidney prognosis in primary NS.
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spelling pubmed-93812842022-08-17 Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study Fujimoto, Keiji Haraguchi, Takatoshi Kumano, Sho Yamazaki, Keita Miyatake, Nobuhiko Nomura, Kanae Mukai, Kiyotaka Okino, Kazuaki Hayashi, Norifumi Adachi, Hiroki Yokoyama, Hitoshi Iida, Yasuo Furuichi, Kengo Int J Nephrol Research Article This retrospective exploratory study aimed to identify early clinical indicators of kidney prognosis in primary nephrotic syndrome (NS). Univariate Cox proportional hazards regression analysis identified clinical parameters in the 2-month period after initiating immunosuppressive therapy (IST); it predicted 40% reduction in the estimated glomerular filtration rate (eGFR) in 36 patients with primary NS. Time-dependent receiver operating characteristic curve analysis was used to evaluate the performance of the predictors for the cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST. The mean follow-up period was 71.9 months. The eGFR was reduced by 40% in four patients. Significant predictors for time to 40% reduction in the eGFR were as follows: an increase in the serum soluble urokinase plasminogen activator receptor (s-suPAR) 2 months after initiating IST (Δs-suPAR (2M); hazard ratio (HR) for every 500 pg/mL increase: 1.36, P=0.006), s-suPAR at 2 months after initiating IST (s-suPAR (2M); HR for every 500 pg/mL increase: 1.13, P=0.015), urinary protein-to-creatinine ratio (u-PCR) (u-PCR (2M); HR for every 1.0 g/gCr increase: 2.94, P=0.003), and urinary liver-type fatty acid-binding protein (u-L-FABP) (u-L-FABP (2M); HR for every 1.0 μg/gCr increase: 1.14, P=0.006). All four factors exhibited high predictive accuracy for cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST, with areas under the receiver operating characteristic curve of 0.92 for Δs-suPAR (2M), 0.87 for s-suPAR (2M), 0.93 for u-PCR (2M), and 0.93 for u-L-FABP (2M). These findings suggest that Δs-suPAR (2M), s-suPAR (2M), u-PCR (2M), and u-L-FABP (2M) could be useful indicators of initial therapeutic response for predicting kidney prognosis in primary NS. Hindawi 2022-08-09 /pmc/articles/PMC9381284/ /pubmed/35983504 http://dx.doi.org/10.1155/2022/2718810 Text en Copyright © 2022 Keiji Fujimoto et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Fujimoto, Keiji
Haraguchi, Takatoshi
Kumano, Sho
Yamazaki, Keita
Miyatake, Nobuhiko
Nomura, Kanae
Mukai, Kiyotaka
Okino, Kazuaki
Hayashi, Norifumi
Adachi, Hiroki
Yokoyama, Hitoshi
Iida, Yasuo
Furuichi, Kengo
Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title_full Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title_fullStr Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title_full_unstemmed Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title_short Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study
title_sort early, noninvasive clinical indicators of kidney prognosis in primary nephrotic syndrome: a retrospective exploratory study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381284/
https://www.ncbi.nlm.nih.gov/pubmed/35983504
http://dx.doi.org/10.1155/2022/2718810
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