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...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | International Journal of Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2022/2718810 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832561764070326272 |
|---|---|
| author | Keiji Fujimoto Takatoshi Haraguchi Sho Kumano Keita Yamazaki Nobuhiko Miyatake Kanae Nomura Kiyotaka Mukai Kazuaki Okino Norifumi Hayashi Hiroki Adachi Hitoshi Yokoyama Yasuo Iida Kengo Furuichi |
| author_facet | Keiji Fujimoto Takatoshi Haraguchi Sho Kumano Keita Yamazaki Nobuhiko Miyatake Kanae Nomura Kiyotaka Mukai Kazuaki Okino Norifumi Hayashi Hiroki Adachi Hitoshi Yokoyama Yasuo Iida Kengo Furuichi |
| author_sort | Keiji Fujimoto |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-4f437a1f4e6341fd99cf3623d1b29215 |
| institution | Kabale University |
| issn | 2090-2158 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Nephrology |
| spelling | doaj-art-4f437a1f4e6341fd99cf3623d1b292152025-02-03T01:24:10ZengWileyInternational Journal of Nephrology2090-21582022-01-01202210.1155/2022/2718810Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory StudyKeiji Fujimoto0Takatoshi Haraguchi1Sho Kumano2Keita Yamazaki3Nobuhiko Miyatake4Kanae Nomura5Kiyotaka Mukai6Kazuaki Okino7Norifumi Hayashi8Hiroki Adachi9Hitoshi Yokoyama10Yasuo Iida11Kengo Furuichi12Department of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of NephrologyDepartment of MathematicsDepartment of NephrologyThis 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.http://dx.doi.org/10.1155/2022/2718810 |
| spellingShingle | Keiji Fujimoto Takatoshi Haraguchi Sho Kumano Keita Yamazaki Nobuhiko Miyatake Kanae Nomura Kiyotaka Mukai Kazuaki Okino Norifumi Hayashi Hiroki Adachi Hitoshi Yokoyama Yasuo Iida Kengo Furuichi Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study International Journal of Nephrology |
| 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 |
| url | http://dx.doi.org/10.1155/2022/2718810 |
| work_keys_str_mv | AT keijifujimoto earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT takatoshiharaguchi earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT shokumano earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT keitayamazaki earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT nobuhikomiyatake earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT kanaenomura earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT kiyotakamukai earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT kazuakiokino earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT norifumihayashi earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT hirokiadachi earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT hitoshiyokoyama earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT yasuoiida earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy AT kengofuruichi earlynoninvasiveclinicalindicatorsofkidneyprognosisinprimarynephroticsyndromearetrospectiveexploratorystudy |