scholarly journals The Unique Difference Between Serum Level of Soluble Urokinase Plasminogen Activator Receptor (suPAR) in Steroid-Resistant Nephrotic Syndrome Children Treated with an Alkylating Agent and Calcineurin Inhibitors

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ahmedz WIdiasta ◽  
Kurnia Wahyudi ◽  
Husna Nugrahapraja ◽  
Yunia Sribudiani ◽  
Dedi Rachmadi

Background: Steroid-resistant nephrotic syndrome (SRNS) is a leading contributor to chronic kidney disease (CKD), and calcineurin inhibitors (CNIs) or monoclonal antibodies are currently the best identified therapy. Meanwhile, some developing countries still use alkylating agents (AA) such as cyclophosphamide (CPA) to treat SRNS due to economic reasons. Objectives: This study aims to determine the employability of soluble urokinase plasminogen activator receptor (suPAR) as a biomarker for monitoring therapy in SRNS children and compare the clinical improvement with those treated with an AA and CNIs. Methods: This was a retrospective cohort study conducted at Hasan Sadikin Hospital, Indonesia. The data was collected from July 2019 to July 2020 from 70 children with FSGS. Clinical signs were evaluated monthly, and serum suPAR level was measured at the third and sixth months following therapy. Two-way repeated measures ANOVA was carried out to compare the differences in suPAR level at baseline with the third and sixth months in SRNS patients who received AA and CNIs. Results: The mean age was nearly similar between the two groups based on the t-test (P = 0.140). Steroid-resistant nephrotic syndrome was more frequent in boys than in girls (P = 0.020), according to the Chi-square test. Baseline serum suPAR level was not significantly different between the two groups. In the third month, the daily urinary protein level was higher in SRNS patients that received the AA compared to the CNIs group (P < 0.001). There was a significant interaction between time and treatment (F(2,138) = 7.203, P = 0.001), with higher suPAR level in SRNS patients that received the AA compared to those administered with CNIs at the 3rd and 6th months, but this difference was not statistically significant (P > 0.05). Conclusions: As a noninvasive tool, suPAR is a promising modality in monitoring SRNS therapy, and CNIs have a tendency to achieve faster remission than the AA.

2021 ◽  
Vol 8 (2) ◽  
pp. 163-174
Author(s):  
Phuong Anh Le Thy ◽  
◽  
Kiem Hao Tran ◽  
Thuy Yen Hoang Thi ◽  
Minh Phuong Phan Thi ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rafal N. Wlazel ◽  
Katarzyna Szwabe ◽  
Agnieszka Guligowska ◽  
Tomasz Kostka

Abstract Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker whose clinical value has been tested in various groups of patients. The aim of the present study was to determine the suPAR level in a previously uninvestigated population of 182, generally healthy, community-dwelling seniors aged 74–89 years. In addition to suPAR level, selected laboratory parameters of heart and kidney function, lipid and C-reactive protein levels were determined. A group of 45 younger individuals aged 24–66 years was used for comparison. The seniors had higher suPAR levels than younger controls: 3.79 ng/mL (95% CI 3.64–3.96 ng/mL) vs. 3.16 ng/mL (95% CI 2.86–3.45 ng/mL). These levels increased further with advancing age, and were similar in women and men. A multiple regression model confirmed that biomarker level was related to cardiac function, renal function and inflammation, and this remained after adjusting for age. These correlation patterns were similar in older women and men.


2021 ◽  
Vol 12 (1) ◽  
pp. 39
Author(s):  
Dorota Różański ◽  
Stanisław Szlufik ◽  
Ryszard Tomasiuk ◽  
Łukasz Milanowski ◽  
Monika Figura ◽  
...  

Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory biomarker elevated in cardiovascular diseases. The aim of this 3-year follow-up prospective study was to evaluate suPAR levels in patients with a first ischemic stroke in correlation with CRP, PCT, NT-proCNP and endothelin 1-21 and to investigate the impact of suPAR on the outcome. Fifty-one patients (mean age 73.7+ = 11.9 years, 26 female and 25 male) were included. Samples were collected on the first (suPAR 1), third (suPAR 3) and seventh days after stroke onset (suPAR 7). Plasma samples were analyzed using ELISA. A phone interview was conducted to collect follow-up information after 24 and 36 months (modified Rankin Scale, mRS). A positive correlation between suPAR levels and other inflammatory biomarkers (except endothelin 3) was observed. A positive correlation between suPAR 3 and mRS score at 24 months was observed (p = 0.042). The logistic regression model revealed no significant effect of suPAR on death occurrence in the first 24 months: suPAR 1 (p = 0.8794), suPAR 3 (p = 0.2757), and suPAR 7 (p = 0.3652). The suPAR level is a potential inflammatory marker in ischemic stroke, and there is a correlation with other markers. There is no major impact on mortality. However, the suPAR level is associated with a degree of disability or dependence in daily activities 2 years after a stroke.


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