Urinary crosslinked fibrin degradation products in glomerular disease

Urinary levels of crosslinked fibrin degradation products (XLFDP) in glomerular disease were measured by radioimmunoassay using monoclonal antibodies. The majority of patients with crescentic glomerulonephritis or focal segmental sclerosis/hyalinosis showed increased levels of urinary XLFDP. Mild to moderately increased levels were seen in some patients with other forms of glomerulonephritis. In focal segmental sclerosis/hyalinosis or membranous nephropathy, however, XLFDP levels correlated with proteinuria and the ratio of XLFDP to proteinuria was lower than in crescentic glomerulonephritis. Although isolated urinary XLFDP is not necessarily an index of intraglomerular coagulation and fibrinolysis, the ratio of XLFDP to proteinuria may provide a useful marker for active glomerular lesions as crescents and/or intraglomerular coagulation and fibrinolysis.