Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis

Introduction. The soluble urokinase-type plasminogen activator receptor (suPAR) has been found to be elevated in primary focal segmental glomerulosclerosis (pFSGS). However, its usefulness as a biomarker for FSGS remains controversial. We conducted a meta-analysis aiming at investigating the signifi...

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Main Authors: Jiwon M. Lee, Jae Won Yang, Andreas Kronbichler, Michael Eisenhut, Gaeun Kim, Keum Hwa Lee, Jae Il Shin
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Immunology Research
Online Access:http://dx.doi.org/10.1155/2019/5679518
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author Jiwon M. Lee
Jae Won Yang
Andreas Kronbichler
Michael Eisenhut
Gaeun Kim
Keum Hwa Lee
Jae Il Shin
author_facet Jiwon M. Lee
Jae Won Yang
Andreas Kronbichler
Michael Eisenhut
Gaeun Kim
Keum Hwa Lee
Jae Il Shin
author_sort Jiwon M. Lee
collection DOAJ
description Introduction. The soluble urokinase-type plasminogen activator receptor (suPAR) has been found to be elevated in primary focal segmental glomerulosclerosis (pFSGS). However, its usefulness as a biomarker for FSGS remains controversial. We conducted a meta-analysis aiming at investigating the significance of suPAR in diagnosing pFSGS. Methods. Electronic databases (PubMed and EMBASE) were searched to identify studies comparing suPAR levels in FSGS patients and controls, from the earliest available date to May 1, 2018. A random-effects model with standardized mean difference (SMD) was used for meta-analyses. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale. Results. A total of 187 articles were screened, and the final analysis included 13 articles. In comparison to healthy controls, serum suPAR levels were significantly increased in pFSGS patients (SMD, 1.07, 95% confidence interval (CI) 0.65 to 1.48; participants=814; studies=9, I2=85%). Higher suPAR levels were also found in patients with pFSGS compared to those with minimal change disease (SMD 0.53, 95% CI 0.22 to 0.84). Of note, such a difference was not found in pediatric groups (SMD 0.42, 95% CI -0.13 to 0.96) while it was more evidently noted in adult patients (SMD 1.32, 95% CI 0.90 to 1.74). Serum suPAR levels did not differ between pFSGS patients in remission compared to those in active proteinuric state (SMD 0.29, 95% CI -0.30 to 0.88). Comparison with membranous nephropathy and IgA nephropathy showed no significant difference. Conclusions. Our meta-analysis demonstrated that, in comparison to both healthy controls and controls with minimal change disease, suPAR levels were significantly higher in adult patients with pFSGS. suPAR levels did not differ between pFSGS patients during the initial period of diagnosis and those in remission.
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spelling doaj-art-5b56bb3918b14ca4ae478f18875b6fd52025-08-20T02:05:13ZengWileyJournal of Immunology Research2314-88612314-71562019-01-01201910.1155/2019/56795185679518Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-AnalysisJiwon M. Lee0Jae Won Yang1Andreas Kronbichler2Michael Eisenhut3Gaeun Kim4Keum Hwa Lee5Jae Il Shin6Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Republic of KoreaDepartment of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Gangwon, Republic of KoreaDepartment of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, AustriaPediatric Department, Luton & Dunstable University Hospital NHS Foundation Trust, Luton, UKKeimyung University College of Nursing, Daegu, Republic of KoreaDepartment of Pediatric Nephrology, Severance Children’s Hospital, Seoul, Republic of KoreaDepartment of Pediatric Nephrology, Severance Children’s Hospital, Seoul, Republic of KoreaIntroduction. The soluble urokinase-type plasminogen activator receptor (suPAR) has been found to be elevated in primary focal segmental glomerulosclerosis (pFSGS). However, its usefulness as a biomarker for FSGS remains controversial. We conducted a meta-analysis aiming at investigating the significance of suPAR in diagnosing pFSGS. Methods. Electronic databases (PubMed and EMBASE) were searched to identify studies comparing suPAR levels in FSGS patients and controls, from the earliest available date to May 1, 2018. A random-effects model with standardized mean difference (SMD) was used for meta-analyses. Risk of bias was assessed using the Newcastle-Ottawa quality assessment scale. Results. A total of 187 articles were screened, and the final analysis included 13 articles. In comparison to healthy controls, serum suPAR levels were significantly increased in pFSGS patients (SMD, 1.07, 95% confidence interval (CI) 0.65 to 1.48; participants=814; studies=9, I2=85%). Higher suPAR levels were also found in patients with pFSGS compared to those with minimal change disease (SMD 0.53, 95% CI 0.22 to 0.84). Of note, such a difference was not found in pediatric groups (SMD 0.42, 95% CI -0.13 to 0.96) while it was more evidently noted in adult patients (SMD 1.32, 95% CI 0.90 to 1.74). Serum suPAR levels did not differ between pFSGS patients in remission compared to those in active proteinuric state (SMD 0.29, 95% CI -0.30 to 0.88). Comparison with membranous nephropathy and IgA nephropathy showed no significant difference. Conclusions. Our meta-analysis demonstrated that, in comparison to both healthy controls and controls with minimal change disease, suPAR levels were significantly higher in adult patients with pFSGS. suPAR levels did not differ between pFSGS patients during the initial period of diagnosis and those in remission.http://dx.doi.org/10.1155/2019/5679518
spellingShingle Jiwon M. Lee
Jae Won Yang
Andreas Kronbichler
Michael Eisenhut
Gaeun Kim
Keum Hwa Lee
Jae Il Shin
Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
Journal of Immunology Research
title Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
title_full Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
title_fullStr Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
title_full_unstemmed Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
title_short Increased Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) Levels in FSGS: A Meta-Analysis
title_sort increased serum soluble urokinase type plasminogen activator receptor supar levels in fsgs a meta analysis
url http://dx.doi.org/10.1155/2019/5679518
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