各種腎疾患における尿中cross-linked FDPについての検討

Abstract

Fibrin/Fibrinogen degradation products (FDP) and cross-linked FDP (XLFDP) have been found in the urine of many patients with renal disease. FDP result from fibrinogenolysis and fibrinolysis. It is useful to detect the urinary XLFDP which results from fibrinolysis in order to diagnose intraglomerular coagulation. I investigated urinary FDP and XLFDP in patients with various renal diseases. Urinary FDP and XLFDP were detected by latex aggregation test in the urine of 96 patients. Urinary XLFDP was measured by enzyme-linked immunosorbent assay (ELISA) using monoclonal antibody in the urine of 140 patients. The positive rates of urinary XLFDP were higher in chronic renal failure, membranous nephropathy and membranous-proliferative glomerulonephritis than in other renal diseases. High levels of urinary XLFDP were found in membranous nephropathy, membranous proliferative glomerulonephritis and non-IgA nephropathy. There was an obvious relationship between urinary XLFDP and the degree of proteinuria, hematuria, serum creatinine and intraglomerular fibrin deposits. The high levels of urinary XLFDP were detected in the case of severe proteinuria, normal and mild hematuria, normal and slightly increased serum creatinine and mild intraglomerular fibrin deposits.