Urinary thrombin: a novel marker of glomerular inflammation for the diagnosis of crescentic glomerulonephritis (prospective observational study)

PloS One
Yasunori KitamotoTakahisa Imamura

Abstract

Crescentic glomerulonephritis (CresGN), an uncommon rapidly progressive disease, is characterized by severe glomerular inflammation with fibrin deposition. The lack of specific CresGN biomarkers delays diagnosis and threatens life. Because fibrin deposits in CresGN glomeruli indicate thrombin generation, we hypothesized that thrombin is excreted in urine and is a specific CresGN biomarker. We measured urinary thrombin activity in 200 untreated patients (17 with CresGN, 183 with primary glomerulonephritis) and controls (8 patients with healed CresGN, 11 with nephrosclerosis, and 10 with tubulointerstitial nephritis, and 66 healthy volunteers). CresGN types included 15 pauci-immune and 2 immune complex. We assessed the diagnostic accuracy of thrombinuria in 169 patients with hematuria and proteinuria. Renal biopsy tissues were immunostained for tissue factor and fibrin. We analyzed the relationship of thrombinuria to plasma thrombin-antithrombin complex, hematuria, proteinuria, glomerular filtration rate, glomerular fibrin deposition, antineutrophil cytoplasmic antibodies (ANCAs), and C-reactive protein (CRP). We studied changes in thrombin activities after glucocorticoid treatment in 12 patients with thrombinuria. The highest th...Continue Reading

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Citations

Sep 24, 2015·Biosensors & Bioelectronics·Longyan ChenJin Zhang
Apr 15, 2018·Pediatrics International : Official Journal of the Japan Pediatric Society·Hiroaki KanaiKanji Sugita
Jan 15, 2021·The Tohoku Journal of Experimental Medicine·Yasunori KitamotoKenji Arizono

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Methods Mentioned

BETA
biopsy
enzyme-linked immunosorbent assay

Software Mentioned

MedCalc
StatView

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