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. 2013 Aug 22;8(8):e71023.
doi: 10.1371/journal.pone.0071023. eCollection 2013.

Urinary uromodulin excretion predicts progression of chronic kidney disease resulting from IgA nephropathy

Jingjing Zhou  1 , Yuqing Chen, Ying Liu, Sufang Shi, Suxia Wang, Xueying Li, Hong Zhang, Haiyan Wang
Affiliations

Urinary uromodulin excretion predicts progression of chronic kidney disease resulting from IgA nephropathy

Jingjing Zhou et al. PLoS One. .

Abstract

Background: Uromodulin, or Tamm-Horsfall protein, is the most abundant urinary protein in healthy individuals. Recent studies have suggested that uromodulin may play a role in chronic kidney diseases. We examined an IgA nephropathy cohort to determine whether uromodulin plays a role in the progression of IgA nephropathy.

Methods: A total of 344 IgA nephropathy patients were involved in this study. Morphological changes were evaluated with the Oxford classification of IgA nephropathy. Enzyme Linked Immunosorbent Assay (ELISA) measured the urinary uromodulin level on the renal biopsy day. Follow up was done regularly on 185 patients. Time-average blood pressure, time-average proteinuria, estimated glomerular filtration rate (eGFR) and eGFR decline rate were caculated. Association between the urinary uromodulin level and the eGFR decline rate was analyzed with SPSS 13.0.

Results: We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort. Urinary uromodulin level was correlated with tubulointerstitial lesions (P = 0.016). Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).

Conclusions: Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Urinary uromodulin levels association with interstitial fibrosis/tubular atrophy.
Median urinary uromodulin level is presented (inter-quartile range [IQR]). All individuals were divided into three groups according to their Oxford interstitial fibrosis/tubular atrophy score. 0: 0–25% 1: 26%–50% 2: >50%. Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels among the three groups.
Figure 2
Figure 2. Urinary uromoudulin levels association with gender.
Median urinary uromodulin level is presented (inter-quartile range [IQR]). Non-parametric Mann–Whitney test was used to test the difference in urinary uromodulin levels between the two groups.
See this image and copyright information in PMC

References

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