Speciality Medical Dialogues
    • facebook
    • twitter
    Login Register
    • facebook
    • twitter
    Login Register
    • Medical Dialogues
    • Education Dialogues
    • Business Dialogues
    • Medical Jobs
    • Medical Matrimony
    • MD Brand Connect
    Speciality Medical Dialogues
    • Editorial
    • News
        • Anesthesiology
        • Cancer
        • Cardiac Sciences
        • Critical Care
        • Dentistry
        • Dermatology
        • Diabetes and Endo
        • Diagnostics
        • ENT
        • Featured Research
        • Gastroenterology
        • Geriatrics
        • Medicine
        • Nephrology
        • Neurosciences
        • Nursing
        • Obs and Gynae
        • Ophthalmology
        • Orthopaedics
        • Paediatrics
        • Parmedics
        • Pharmacy
        • Psychiatry
        • Pulmonology
        • Radiology
        • Surgery
        • Urology
    • Practice Guidelines
        • Anesthesiology Guidelines
        • Cancer Guidelines
        • Cardiac Sciences Guidelines
        • Critical Care Guidelines
        • Dentistry Guidelines
        • Dermatology Guidelines
        • Diabetes and Endo Guidelines
        • Diagnostics Guidelines
        • ENT Guidelines
        • Featured Practice Guidelines
        • Gastroenterology Guidelines
        • Geriatrics Guidelines
        • Medicine Guidelines
        • Nephrology Guidelines
        • Neurosciences Guidelines
        • Obs and Gynae Guidelines
        • Ophthalmology Guidelines
        • Orthopaedics Guidelines
        • Paediatrics Guidelines
        • Psychiatry Guidelines
        • Pulmonology Guidelines
        • Radiology Guidelines
        • Surgery Guidelines
        • Urology Guidelines
    LoginRegister
    Speciality Medical Dialogues
    LoginRegister
    • Home
    • Editorial
    • News
      • Anesthesiology
      • Cancer
      • Cardiac Sciences
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endo
      • Diagnostics
      • ENT
      • Featured Research
      • Gastroenterology
      • Geriatrics
      • Medicine
      • Nephrology
      • Neurosciences
      • Nursing
      • Obs and Gynae
      • Ophthalmology
      • Orthopaedics
      • Paediatrics
      • Parmedics
      • Pharmacy
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
    • Practice Guidelines
      • Anesthesiology Guidelines
      • Cancer Guidelines
      • Cardiac Sciences Guidelines
      • Critical Care Guidelines
      • Dentistry Guidelines
      • Dermatology Guidelines
      • Diabetes and Endo Guidelines
      • Diagnostics Guidelines
      • ENT Guidelines
      • Featured Practice Guidelines
      • Gastroenterology Guidelines
      • Geriatrics Guidelines
      • Medicine Guidelines
      • Nephrology Guidelines
      • Neurosciences Guidelines
      • Obs and Gynae Guidelines
      • Ophthalmology Guidelines
      • Orthopaedics Guidelines
      • Paediatrics Guidelines
      • Psychiatry Guidelines
      • Pulmonology Guidelines
      • Radiology Guidelines
      • Surgery Guidelines
      • Urology Guidelines
    • Home
    • Latest News
    • Protein shown to be...

    Protein shown to be predictor of kidney damage in children : JAMA

    Written by Anjali Nimesh Nimesh Published On 2017-09-07T09:30:40+05:30  |  Updated On 7 Sept 2017 9:30 AM IST
    Protein shown to be predictor of kidney damage in children : JAMA

    High levels of a protein known as suPAR, which has been shown to be a marker and likely cause of kidney damage, is as reliably predictive in children as in adults, according to results of a study published online today in JAMA Pediatrics, a clinical publication of the American Medical Association.


    The findings represent "the first documentation of an association between suPAR level and loss of kidney function in children and adolescents," the paper notes.


    Dr. Jochen Reiser, who led the study, calls the results "an astounding finding. The causes of kidney disease are very different in children and adults, yet suPAR has essentially the same association with decline in kidney function in children as in adults."


    "That argues that suPAR may be an overarching contributor to the progression of kidney disease, regardless of the underlying etiologies," adds Reiser, the Ralph C. Brown, MD, Professor and chairperson of the Department of Internal Medicine at Rush University Medical Center.


    'This is the most promising predictor of kidney disease out there'


    The study examined 898 children and adolescents with mild to moderate kidney disease who were enrolled in one of two large cohorts, the 4C Study and the ESCAPE Trial, at a total of 30 hospitals in 13 European countries. The mean age at enrollment was 11.9 years.


    Study participants' suPAR levels were gauged when they enrolled in their original trials, and their kidney function was measured regularly as part of the two studies. Dr. Franz Schaefer, head of pediatric nephrology at Heidelberg University Hospital in Heidelberg, Germany, followed up with the subjects for the new study by assessing participants' kidney function. The median duration of follow-up time was 3.1 years.


    Adjusting for additional risk factors such as elevated blood pressure and already decreased kidney function, damage was more likely to have progressed in the children who had demonstrated high suPAR levels at the beginning of the study. About half the children had lost the use of their kidneys. Renal survival was 65 percent in children with the lowest suPAR levels, but only 36 percent in those with the highest levels.


    "Measuring suPAR may become more routine in clinical practice in the future to more accurately predict who's going to need dialysis," Reiser said. "This is the most promising predictor of kidney disease out there."


    Elevated suPAR More Indicative of CKD Than Congenital Anomolies


    Where adults most often develop chronic kidney disease (CKD) as a result of diabetes, high blood pressure or other conditions, CKD in children is largely caused by congenital malformations, hereditary disorders and birth defects. However, even among the 71 percent of children in this study who had congenital anomalies of the kidneys or urinary tract, high levels of suPAR were still an accurate predictor of which participants would lose kidney function.


    "Some kids who looked structurally pretty bad didn't progress [in terms of kidney disease]," Reiser said.


    In adults, lifestyle factors such as smoking, weight gain and frequent infections can raise suPAR levels. Even though these factors didn't affect the children in the study, Reiser's team still found median suPAR concentrations in some participants that were more than twice the levels found in healthy control participants.


    "Children have very active immune systems, they may react stronger to infections, which could explain their higher suPAR levels. Also, many of them are born with reduced functioning kidney mass due to genetic abnormalities, so their kidneys must work harder and tend to 'wear out' early. High suPAR may reflect increased renal tissue turnover and/or deranged repair mechanisms," said Schaefer.


    Elevated suPAR More Indicative of CKD Than Congenital Anomalies


    Everyone has urokinase plasminogen activator receptor (uPAR) in their cells; suPAR is a soluble version of the protein that circulates in the blood. In a series of studies over the past several years, Reiser and co-researchers have shown repeatedly in different settings that suPAR is a reliable early marker for CKD, and also likely a cause. They hope the findings will lead to new and safe treatments.


    It appears that elevated levels of suPAR distort the structure and activity of some variants of the protein integrin, causing it to attack the kidney's podocytes, cells that are important in filtering waste. suPAR might act on additional pathways that lead to kidney injury, because in the latest study, suPAR levels are also relevant for progression of birth-related structural kidney diseases.


    Reiser likens the effect of suPAR on the kidneys to that of cholesterol on the heart -- damage can result in both cases if levels rise too high. Even compared with other diseases with strong causative associations, including breast cancer and the BRCA1 gene, and lung cancer and smoking, high suPAR levels in some cases are strikingly predictive of CKD and kidney loss.


    In the pediatric study, "If an eight-year-old child has mild kidney disease but high suPAR, by age 13, chances are that kidney will be gone," Reiser said.


    In light of the new JAMA Pediatrics paper, parents of children at risk for chronic kidney disease will want to be vigilant about vaccinations and other measures to help their children avoid infections, because they are known causes of suPAR spikes. This relationship may explain the link between these events and progressive decline in kidney function, said Dr. Howard Trachtman, a nephrologist and professor at New York University's Langone Health, and co-author on the study.


    Reiser said he was grateful his team was able to collaborate and by such assemble such a large cohort of children with CKD. The 4C Study looked at the causes and consequences of cardiovascular disease in children and adolescents with kidney disease, beginning in 2009. The ESCAPE Trial, a five-year study first published in 2009, explored the efficacy of blood pressure interventions on the progress of CKD in children.

    chronic kidney diseaseDr Franz SchaeferDr Jochen Reiserhigh blood pressureJAMA Pediatricskidney damage

    Disclaimer: This site is primarily intended for healthcare professionals. Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription. Use of this site is subject to our terms of use, privacy policy, advertisement policy. © 2020 Minerva Medical Treatment Pvt Ltd

    Anjali Nimesh Nimesh
    Anjali Nimesh Nimesh
      Show Full Article
      Next Story
      Similar Posts
      NO DATA FOUND

      • Email: info@medicaldialogues.in
      • Phone: 011 - 4372 0751

      Website Last Updated On : 12 Oct 2022 7:06 AM GMT
      Company
      • About Us
      • Contact Us
      • Our Team
      • Reach our Editor
      • Feedback
      • Submit Article
      Ads & Legal
      • Advertise
      • Advertise Policy
      • Terms and Conditions
      • Privacy Policy
      • Editorial Policy
      • Comments Policy
      • Disclamier
      Medical Dialogues is health news portal designed to update medical and healthcare professionals but does not limit/block other interested parties from accessing our general health content. The health content on Medical Dialogues and its subdomains is created and/or edited by our expert team, that includes doctors, healthcare researchers and scientific writers, who review all medical information to keep them in line with the latest evidence-based medical information and accepted health guidelines by established medical organisations of the world.

      Any content/information on this website does not replace the advice of medical and/or health professionals and should not be construed as medical/diagnostic advice/endorsement or prescription.Use of this site is subject to our terms of use, privacy policy, advertisement policy. You can check out disclaimers here. © 2025 Minerva Medical Treatment Pvt Ltd

      © 2025 - Medical Dialogues. All Rights Reserved.
      Powered By: Hocalwire
      X
      We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok