Significance of urinary fatty acid-binding protein 4 level as a possible biomarker for the identification of minimal change disease in patents with nephrotic-range proteinuria

BMC Nephrology

Megumi Matsumoto¹  Akiko Sakai¹  Masayuki Koyama¹  Yufu Gocho¹  Marenao Tanaka¹  Masato Furuhashi¹  Norihito Moniwa¹  Yukimura Higashiura¹  Tetsuji Miura¹  Takuto Maeda²  Hideki Takizawa²  Yayoi Ogawa³ 

[1] Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, 060-8543, Sapporo, Japan;Department of Nephrology, Teine Keijinkai Hospital, Sapporo, Japan;Hokkaido Renal Pathology Center, Sapporo, Japan;

关键词: Fatty acid-binding protein;    Nephrotic syndrome;    Membranous nephropathy;    Minor glomerular abnormalities;    Kidney biopsy;   

DOI  :  10.1186/s12882-020-02122-y

来源: Springer

【 摘 要 】

BackgroundFatty acid-binding protein 4 (FABP4), but not FABP1 (liver-type FABP), is ectopically induced in injured glomerular endothelial cells, and urinary FABP4 (U-FABP4) level is associated with proteinuria and renal dysfunction in a general population.MethodsThe clinical significance of U-FABP4 was investigated in 81 patients (male/female: 43/38, age: 57 ± 17 years) who underwent kidney biopsy.ResultsU-FABP4 was negatively correlated with estimated glomerular filtration rate (eGFR) (r = − 0.56, P < 0.01) and was positively correlated with age, blood pressure, triglycerides, proteinuria (r = 0.58, P < 0.01), plasma FABP4 and urinary FABP1 (U-FABP1) (r = 0.52, P < 0.01). Multivariable regression analysis showed that eGFR, proteinuria and U-FABP1 were independent predictors of U-FABP4. The level of U-FABP4, but not that of proteinuria, eGFR or U-FABP1, in minimal change nephrotic syndrome (MCNS) was significantly lower than the level in membranous nephropathy (MN) and that in diabetic nephropathy. Receiver operating characteristic curve analysis indicated that U-FABP4 level ≤ 0.78 μg/gCr predicted MCNS in patients who had nephrotic-range proteinuria with a high level of accuracy. When divided by the median value of U-FABP4 at baseline in 33 of the 81 patients who could be followed up, the yearly change (post–pre) in eGFR in the low U-FABP4 group was significantly greater than that in the high U-FABP4 group (median: 11.0 vs. -5.0 mL/min/1.73m2/year).ConclusionsU-FABP4 level is independently associated with proteinuria and renal dysfunction in patients with glomerular kidney disease. A low U-FABP4 level may predict MCNS in patients with nephrotic syndrome and would be a useful biomarker for differential diagnosis of MCNS and MN, which are common causes of nephrotic syndrome.

【 授权许可】

CC BY