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Urinary podocyte mRNA excretion in children with D+HUS: a potential marker of long-term outcome

Laura De Petris1, Jilma Patrick, Erica Christen

  • 1Department of Pediatrics, Washington University, St. Louis, Missouri, USA.

Renal Failure
|August 25, 2006
PubMed

Insights

Urinary podocyte mRNA is detectable in children with diarrhea-associated hemolytic uremic syndrome (D+HUS), indicating potential podocyturia. Further research is needed to link these biomarkers to long-term kidney outcomes in D+HUS patients.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Molecular Diagnostics

Background:

  • Diarrhea-associated hemolytic uremic syndrome (D+HUS) can cause acute kidney injury and podocyte damage.
  • Podocyte loss is a concern in D+HUS, potentially impacting long-term renal function.

Purpose of the Study:

  • To investigate the detectability of urinary podocyte protein mRNA in children with D+HUS.
  • To assess if urinary podocyte mRNA levels serve as a biomarker for poor long-term outcomes in D+HUS.

Main Methods:

  • Real-time PCR was used to measure synaptopodin and nephrin mRNA levels in urine samples.
  • Urine was collected daily from hospitalized children with D+HUS and from healthy volunteers.
  • Patients were stratified based on urinary mRNA levels compared to controls.

Main Results:

  • Eighty percent of D+HUS patients (12/15) exhibited increased urinary podocyte mRNA excretion.
  • High levels of synaptopodin mRNA were found in 73% and nephrin mRNA in 33% of patients.
  • Follow-up data in 13 patients showed normal blood pressure, urinalysis, and serum creatinine.

Conclusions:

  • Podocyte mRNA can be isolated from routine urine samples in children with D+HUS.
  • The majority of D+HUS patients demonstrate podocyturia, evidenced by synaptopodin and nephrin mRNA excretion.
  • Larger studies are necessary to establish the predictive value of these urinary biomarkers for renal prognosis in D+HUS.
Abstract

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