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01-11-2019 | Glomerulonephritis | Original Article

Urinary apolipoprotein AI in children with kidney disease

Authors: Amanda J. Clark, Kathy Jabs, Tracy E. Hunley, Deborah P. Jones, Rene G. VanDeVoorde, Carl Anderson, Liping Du, Jianyong Zhong, Agnes B. Fogo, Haichun Yang, Valentina Kon

Published in: Pediatric Nephrology | Issue 11/2019

Abstract

Background

Although high-density lipoprotein (HDL) modulates many cell types in the cardiovascular system, little is known about HDL in the kidney. We assessed urinary excretion of apolipoprotein AI (apoAI), the main protein in HDL.

Methods

We enrolled 228 children with various kidney disorders and 40 controls. Urinary apoAI, albumin, and other markers of kidney damage were measured using ELISA, apoAI isoforms with Western blot, and renal biopsies stained for apoAI.

Results

Patients followed in nephrology clinic had elevated urinary apoAI vs. controls (median 0.074 μg/mg; interquartile range (IQR) 0.0160–0.560, vs. 0.019 μg/mg; IQR 0.004–0.118, p < 0.001). Patients with tubulopathies, renal dysplasia/congenital anomalies of the kidney and urogenital tract, glomerulonephritis, and nephrotic syndrome (NS) in relapse had the greatest elevations (p ≤ 0.01). Patients with NS in remission, nephrolithiasis, polycystic kidney disease, transplant, or hypertension were not different from controls. Although all NS in relapse had higher apoAI excretion than in remission (0.159 vs. 0.0355 μg/mg, p = 0.01), this was largely driven by patients with focal segmental glomerulosclerosis (FSGS). Many patients, especially with FSGS, had increased urinary apoAI isoforms. Biopsies from FSGS patients showed increased apoAI staining at proximal tubule brush border, compared to diffuse cytoplasmic distribution in minimal change disease.

Conclusions

Children with kidney disease have variably increased urinary apoAI depending on underlying disease. Urine apoAI is particularly elevated in diseases affecting proximal tubules. Kidney disease is also associated with high molecular weight (HMW) apoAI isoforms in urine, especially FSGS. Whether abnormal urinary apoAI is a marker or contributor to renal disease awaits further study.

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Title: Urinary apolipoprotein AI in children with kidney disease
Authors: Amanda J. Clark
Kathy Jabs
Tracy E. Hunley
Deborah P. Jones
Rene G. VanDeVoorde
Carl Anderson
Liping Du
Jianyong Zhong
Agnes B. Fogo
Haichun Yang
Valentina Kon
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Glomerulonephritis
Nephrotic Syndrome
Published in: Pediatric Nephrology / Issue 11/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04289-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Urinary apolipoprotein AI in children with kidney disease

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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