期刊
RENAL FAILURE
卷 28, 期 6, 页码 475-482出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/08860220600778902
关键词
diarrhea-associated hemolytic uremic syndrome (D plus HUS); podocyte; nephrin; synaptopodin; mRNA excretion; long-term prognosis; biomarker
资金
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK052147] Funding Source: NIH RePORTER
- NIDDK NIH HHS [DK52147] Funding Source: Medline
Background. Diarrhea-associated hemolytic uremic syndrome (D+HUS) causes acute renal failure and may lead to podocyte loss. Objective. To determine if the urinary mRNA excretion of podocyte proteins is detectable in children with D+HUS and if it is a biomarker of a poor long-term outcome. Methods. Patients were randomly selected from participants in the SYNSORB Pk((R)) trial. Urine samples were collected daily during the first week of hospitalization. Specimens were also obtained in healthy volunteers. Synaptopodin and nephrin mRNA levels were measured using real-time PCR. Results. Fifteen children, aged 4.9 +/- 2.8 years, were studied. Patients were categorized based on urinary mRNA levels into normal ( marker: GAPDH <= mean + SD) or high ( marker: GAPDH > mean + SD) in controls. Twelve patients (80%) had increased urinary podocyte mRNA excretion; 11 (73%) had high synaptopodin and 5 (33%) had high nephrin mRNA levels. Follow-up data were available in 13/15 patients, all of whom had normal blood pressure, urinalysis, and serum creatinine concentration. Conclusion. The isolation of podocyte mRNA from routine urine samples is feasible in children with D+HUS. Most patients have podocyturia based on synaptopodin and nephrin mRNA excretion. Larger studies with extended follow-up are required to determine the relationship of these biomarkers to long-term renal prognosis in D+HUS.
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