Conclusions: RPGN if diagnosed early and treated aggressively
is salvageable. Early Renal biopsy is useful Selleck CH5424802 in deciding treatment plan and prognostication. YAMANARI TOSHIO1, SUGIYAMA HITOSHI1, MORINAGA HIROSHI1, KITAGAWA MASASHI1, ONISHI AKIFUMI1, OGAWA AYU1, KIKUMOTO YOKO1, KITAMURA SHINJI1, MAESHIMA YOHEI1, OGAWA DAISUKE1,2, SHIKATA KENICHI1,3, OHMOTO YASUKAZU4, MAKINO HIROHUMI1 1Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 2Department of Diabetic Nephropathy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; 3Center for Innovative Clinical Medicine,
Okayama University Hospital; 4Otsuka Pharmaceutical Co., Ltd. Introduction: TFF3 plays essential roles in mucosal surface maintenance and reconstitution. A decrease in the urinary levels of TFF3 is associated with acute kidney injury in animal models. Circulating serum TFF3 is significantly increased Midostaurin in patients with chronic kidney disease (CKD) in a recent report. However, whether the urinary levels of TFF3 are associated with renal dysfunction in patients with CKD is unclear. Methods: We analyzed the urinary TFF (uTFF) levels in spot urine samples from 216 patients with CKD, and assessed the relationships among the uTFF, proteinuria and kidney function. Patients were prospectively followed for three years for doubling of the baseline serum creatinine concentration much and the initiation of renal replacement therapy. Results: The excretion of uTFF3 significantly increased with the extent of albuminuria (P < 0.0001), urinary α1 microglobulin (P < 0.0001) and urinary β2 microglobulin (P < 0.0001) and the decline in the eGFR (P < 0.0001). A multivariate logistic regression analysis
showed that the patients with higher levels of uTFF3 were more likely to have CKD stage ≥G3b (P < 0.01). A longitudinal analysis demonstrated that patients with a higher uTFF3, in combination with macroalbuminuria, had a significantly worse renal prognosis (Log rank, P < 0.0001). The levels of urinary TFF3 in the renal end-point group were significantly higher than those in the renal survival group (P < 0.01). The AUC of uTFF3 for predicting the progression of CKD (0.879) was significantly higher than that of albuminuria (0.692) (P < 0.0001). The levels of uTFF1 and uTFF2 did not correlate with albuminuria. Conclusions: The excretion of uTFF3 is therefore significantly associated with albuminuria and a decline in the renal function. Moreover, the uTFF3 level can be used as a novel biomarker to predict the renal outcomes in CKD patients.