Expression changes of soluble urokinase-type plasminogen activator receptor and soluble triggering receptors expressed by myeloid cell-1 in serum of children with primary nephrotic syndrome and their clinical significance

Abstract

Objective To investigate the expression changes of soluble urokinase-type plasminogen activator receptor (suPAR) and soluble triggering receptors expressed by myeloid cell-1(sTREM-1) in serum of children with primary nephrotic syndrome(PNS) and their clinical significance. Methods A total of 92 cases of newly diagnosed PNS children were selected in Central Hospital of Yidu Affiliated to Weifang Medical College from June 2014 to September 2016.According to presence or absence of acute tubular necrosis, they were divided into acute renal injury group (27 cases) and non-acute renal injury group (65 cases). According to pathology type, they were divided into mesangial proliferative glomerulonephritis (30 cases), focal segmental glomerulosclerosis (23 cases), membranous nephropathy (18 cases), minimal change disease (14 cases) and membrane proliferative glomerulonephritis (7 cases). In the same period, 45 healthy children were selected as the healthy control group.The clinical data were collected.The serum levels of suPAR and sTREM-1 were measured by adopting enzyme-linked immunosorbent assay (ELISA). Results The levels of total cholesterol(TC), triglycerides(TG), uric acid(UA), urinary protein/creatinine, 24 h urinary protein, urinary N-acetyl-β-glucosaminidase(NAG) and β2-microglobulin(MG) in children with PNS were higher than those in the healthy control group, while serum albumin(ALB) was lower than that in the healthy control group, and the differences were statistically significant (all P<0.05). The serum levels of suPAR and sTREM-1 in PNS patients were (133.09±62.48) ng/L and (79.29±34.68), respectively, which were significantly higher than those in the healthy control group[(31.11±11.61) ng/L and (25.08±8.10) ng/L](t=51.714, 49.435; all P=0.000). The serum levels of suPAR and sTREM-1 in acute renal injury group were (188.82±32.21) ng/L and (109.11±24.78) ng/L, respectively, which were significantly higher than those in non-acute renal injury group [(75.96±28.69) ng/L and (52.23±14.07) ng/L] and healthy control group [(31.11±11.61) ng/L and (25.08±8.10) ng/L] (F=16 739.607, 10 487.256, all P=0.000). The serum levels of suPAR and sTREM-1 in children with focal segmental glomerulosclerosis and membrane proliferative glomerulonephritis were higher than those with minimal change disease, membranous nephropathy and mesangial proliferative glomerulonephritis, and the differences were statistically significant (all P<0.05). Pearson correlation analysis results showed that the serum levels of suPAR and sTREM-1 were positively correlated with TC, TG, urinary protein/creatinine, 24 h urinary protein, urinary NAG and β2-MG (all P<0.05), while negatively correlated with ALB (P<0.05). Conclusions The serum levels of suPAR and sTREM-1 are elevated in children with PNS, and which are related with acute renal injury and pathological type, which can reflect the degree of renal tubular disease and kidney function to a certain extent. Key words: Primary nephrotic syndrome; Soluble urokinase-type plasminogen activator receptor; Soluble triggering receptors expressed by myeloid cell-1; Child