Related Experiment Video
Updated: Mar 29, 2026
Highly Sensitive Measurement of Glomerular Permeability in Mice with Fluorescein Isothiocyanate-polysucrose 70
Published on: August 9, 2019
Verification of the Utility of Urinary L-FABP as a Predictor of Impaired Renal Function Based on Its Relationship
1National Hospital Organization Kumamoto Saishun Medical Center, 2659 Suya, Koshi 861-1196, Kumamoto, Japan.
Insights
Urinary L-FABP may predict kidney function decline in diabetic or hypertensive patients. High levels indicate a faster estimated glomerular filtration rate (eGFR) decrease, suggesting its use as an early biomarker for chronic kidney disease (CKD).
Area of Science:
- Nephrology
- Biomarker Discovery
- Clinical Chemistry
Background:
- Chronic kidney disease (CKD) progression in diabetic and hypertensive patients increases risks of end-stage renal failure and vascular mortality.
- Early diagnosis and prognosis of CKD are crucial, necessitating the development of reliable urinary biomarkers.
- Current diagnostic methods may not adequately predict disease progression in its early stages.
Purpose of the Study:
- To investigate the potential of urinary liver-fatty acid-binding protein (L-FABP) as a biomarker for predicting renal function decline.
- To evaluate the association between baseline urinary L-FABP levels and the rate of estimated glomerular filtration rate (eGFR) decline in patients with diabetes or hypertension.
- To assess the predictive utility of urinary L-FABP for renal function decline in patients with preserved eGFR.
Main Methods:
- A two-year prospective observational study involving 185 outpatients.
- Classification of patients into high (>8.4 μg/g·Cr) and low (≤8.4 μg/g·Cr) urinary L-FABP groups at baseline.
- Evaluation of the rate of eGFR decline and assessment of predictive utility using ROC curve analysis and logistic regression.
Main Results:
- A synergistic effect was observed between urinary L-FABP levels and time on eGFR decline in patients with diabetes or hypertension and eGFR ≥ 60 mL/min/1.732 m².
- Patients with high baseline urinary L-FABP levels showed a significantly faster eGFR decline compared to those with low levels.
- Urinary L-FABP demonstrated potential as a predictor of renal function decline in this patient cohort.
Conclusions:
- Urinary L-FABP is a potential predictor of renal function decline in diabetic and hypertensive patients with maintained eGFR.
- Urinary L-FABP may reflect tubulointerstitial damage and renal microcirculatory impairment.
- Urinary L-FABP is anticipated to be a valuable biomarker for early diagnosis and prognosis of CKD.
Abstract:
Background: In patients with diabetes or hypertension, if appropriate intervention is not initiated early in the course of kidney disease, not only does the risk of progressing to end-stage renal failure increase, but mortality associated with vascular complications also rises as the disease progresses; therefore, there is an urgent need to develop urinary biomarkers that enable early diagnosis and prediction of disease progression. Methods: This two-year prospective observational study involved 185 outpatients. Patients were classified into two groups based on their baseline urinary L-FABP levels relative to the reference value of 8.4 μg/g·Cr at the start of the study. The rate of eGFR decline during the observation period was evaluated. Results: The results showed an interaction (synergistic effect) between urinary L-FABP and time in patients with diabetes or hypertension who had an eGFR of at least 60 mL/min/1.732 m2/kg/1.732 m2. Patients with high urinary L-FABP levels (>8.4 μg/g·Cr) exhibited a notably faster eGFR decline compared with those with low levels (≤8.4 μg/g·Cr). This finding suggests the potential of urinary L-FABP as a predictor of renal function decline; we evaluated this utility using the area under the ROC curve (AUC) and logistic regression analysis. The results indicate that urinary L-FABP holds potential as a predictor of renal function decline in diabetic or hypertensive patients with preserved eGFR. Conclusions: Among the analysis groups in which the validation was conducted, it was demonstrated that urinary L-FABP holds potential as a predictor of renal function decline in patients with diabetes or hypertension who have a maintained eGFR. Given that urinary L-FABP is thought to reflect tubulointerstitial damage associated with renal microcirculatory impairment, its future utility as a urinary biomarker for the early diagnosis and prognosis of chronic kidney disease (CKD) is anticipated.
Related Concept Videos
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:24Serum Studies: Renal Function Tests
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:23Renal Clearance
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...