Abstract: TH-PO103

Urine Biomarkers’ Efficacy as a Disease-Activity Parameter for Children with IgA Nephropathy

Session Information

Category: Glomerular

  • 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine

Authors

  • Hama, Taketsugu, Wakayama Medical University, Wakayama, Japan
  • Tanaka, Yu, Wakayama Medical University, Wakayama, Japan
  • Sato, Masashi, Wakayama Medical University, Wakayama, Japan
  • Mukaiyama, Hironobu, Wakayama Medical University, Wakayama, Japan
  • Togawa, Hiroko, Wakayama Medical University, Wakayama, Japan
  • Shima, Yuko, Wakayama Medical University, Wakayama, Japan
  • Suzuki, Hiroyuki, Wakayama Medical University, Wakayama, Japan
  • Nakanishi, Koichi, Graduate School of Medicine, University of the Ryukyus, Nishihara-cho, Japan
  • Yoshikawa, Norishige, Wakayama Medical University, Wakayama, Japan
Background

Although there have been several reports of biomarkers in adults, few studies have reported their use in pediatric patients, especially non-invasive methods. Several biomarkers are thought to be useful for differential diagnosis in kidney diseases. However, it is still unknown which biomarkers are more reliable in childhood IgA nephropathy (IgAN). Moreover, there are few reports about the efficacy of biomarkers, especially non-invasive methods as a disease-activity parameter in IgAN.

Methods

We compare several biomarkers from cells in urine samples between patients with IgAN and other renal diseases. And we assess the correlation between biomarkers from urine of pediatric patients with IgAN and their clinical and pathological status. Fifty consecutive patients with kidney diseases (18 nephrotic syndrome, 13 IgAN, 3 Henoch-Schönlein Purpura Nephritis, 1 Lupus, 1 Membranoproliferative Glomerulonephritis, 5 isolated hematuria, 2 isolated proteinuria, 7 others) at our hospital were enrolled. We examined by quantitative real time PCR and compared the expression levels of urine liver fatty acid-binding protein (L-FABP), kidney injury molecule-1 (KIM-1), Cubilin, interleukin-18 (IL-18), neutrophil gelatinase-associated lipocalin (NGAL), Megalin, podocin and Thy1 between IgAN patients and others.

Results

IgAN patients showed significantly lower levels of L-FABP1 (p<0.01), Megalin (p=0.03), Thy1 (p=0.02) and Cubilin (p<0.01) than other patients. Only KIM-1 expression in IgAN patients correlated with proteinuria (p=0.01) and hematuria (p=0.03). IgAN patients with crescents expressed a significantly higher level of IL-18 (p=0.03) than IgAN patients with no crescent pathologic changes.

Conclusion

Some kinds of biomarkers from urine of IgAN patients have potential to diagnose IgAN, predict disease-activity and pathological findings of glomerular crescents. Urine biomarkers are effective invasive tools for long-term follow up for IgAN patients.

Funding

  • Government Support - Non-U.S.