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Observational Study
. 2022 Apr 2;23(1):128.
doi: 10.1186/s12882-022-02764-0.

Clinical value of serum cholinesterase levels in Nephrotic syndrome: an observational study

Kimihiko Goto  1   2 , Keiji Kono  3 , Hideki Fujii  3 , Shunsuke Goto  3 , Shinichi Nishi  3
Affiliations
Observational Study

Clinical value of serum cholinesterase levels in Nephrotic syndrome: an observational study

Kimihiko Goto et al. BMC Nephrol. .

Abstract

Background: Nephrotic syndrome (NS) results in massive proteinuria and hypoalbuminemia, which are responsible for a compensatory increase in protein synthesis in the liver. Serum cholinesterase (ChE) also increases in NS. However, its clinical value is not fully elucidated.

Methods: In this study, 184 patients with NS who underwent kidney biopsy were included. The patients were divided into two groups according to serum ChE levels, as follows: hypercholinesterasemia (HC) and non-hypercholinesterasemia (NHC) groups. The clinical factors were compared between the two groups.

Results: The HC group had significantly more severe proteinuria and higher prevalence of high selective proteinuria than the NHC group. Furthermore, the prevalence of minimal change nephrotic syndrome (MCNS) was significantly higher in the HC group than that in the NHC group. Multivariate analysis revealed that the severity of proteinuria and MCNS were significantly associated with HC.

Conclusion: In this study, HC in NS was associated with the severity of proteinuria and MCNS, and could help clinicians predict the histological diagnosis of NS.

Keywords: Cholinesterase; Minimal change nephrotic syndrome; Nephrotic syndrome.

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Conflict of interest statement

All authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Comparison of clinical data on proteinuria between the two groups. a: The amount of proteinuria. b: The proportion of patients with high selective proteinuria (selectivity index of proteinuria ≤0.2). Abbreviations; HC: hyper-cholinesterasemia, NHC: non hyper-cholinesterasemia
Fig. 2
Fig. 2
Comparison of histopathological diagnosis of NS between the two groups. Abbreviations; NS: nephrotic syndrome, HC: hyper-cholinesterasemia, NHC: non hyper-cholinesterasemia, FSGS: focal segmental glomerulosclerosis, MCNS: minimal change nephrotic syndrome, MN: membranous nephropathy
Fig. 3
Fig. 3
Relationship between the prevalence of HC, the amount of proteinuria and histopathological diagnosis. Abbreviations; HC: hyper-cholinesterasemia, MCNS: minimal change nephrotic syndrome. T: tertile
Fig. 4
Fig. 4
Distribution of (a) serum T-chol and (b) serum ChE levels. a Distribution of serum T-chol levels. White bar; Non-hypercholesteremia, Black bar; hypercholesteremia. b Distribution of serum ChE levels. White bar; NHC, Black bar; HC. Abbreviations; T-chol: Total-cholesterol, ChE: cholinesterase, HC: hyper-cholinesterasemia, NHC: non hyper-cholinesterasemia, MCNS: minimal change nephrotic syndrome
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