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Pediatric Nephrology
Published in: Pediatric Nephrology 4/2016

01-04-2016 | Original Article

Distinct urinary lipid profile in children with focal segmental glomerulosclerosis

Authors: Elif Erkan, Xueheng Zhao, Kenneth Setchell, Prasad Devarajan

Published in: Pediatric Nephrology | Issue 4/2016

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Abstract

Background

Focal segmental glomerulosclerosis (FSGS) accounts for the majority of new-onset end-stage renal disease (ESRD) during adolescence. FSGS treatment is a great challenge for pediatric nephrologists due to intertwined molecular pathways underlining its complex pathophysiology. There is emerging evidence showing that perturbed lipid metabolism plays a role in the pathophysiology of FSGS.

Methods

We postulate that the nephrotic milieu in FSGS differs from minimal change disease (MCD) and that urinary lipidomics can be used as a tool for early diagnosis of FSGS. We explored the urinary lipid profile of patients with FSGS and MCD using an unbiased metabolomics approach.

Results

We discovered a unique lipid signature characterized by increased concentration of fatty acid (FA) and lysophosphatidylcholines (LPC) and a decrease in urinary concentration of phosphatidylcholine (PC) in patients with FSGS. These findings indicate increased metabolism of membrane phospholipid PC by phospholipase A2 (PLA2), resulting in higher urinary concentrations of LPC and FA.

Conclusions

We propose that increased PC by-products can be used as a biomarker to diagnose FSGS and shed light on the mechanism of tubular and podocyte damage. Validation of identified urinary lipids as a biomarker in predicting the diagnosis and progression of FSGS in a larger patient population is warranted.
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Metadata
Title
Distinct urinary lipid profile in children with focal segmental glomerulosclerosis
Authors
Elif Erkan
Xueheng Zhao
Kenneth Setchell
Prasad Devarajan
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 4/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3239-7

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