Urinary plasminogen may be independently linked to risk of progression to ESKD
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Key takeaways:
- Adjusted Log2uPlasminogen/cr was significantly linked to end-stage kidney disease.
- The ratio of measured to expected urine plasmin(ogen) was independently tied to ESKD.
Urinary plasminogen and the ratio of measured to expected plasminogen may be independently linked to the risk of progression to end-stage kidney disease, data show.
“Glomerular disorders, whether primary or secondary, represent a major cause of ESKD worldwide and an important cause of morbidity and mortality among children and adults,” Marina de Cos, a postdoctoral researcher at the Icahn School of Medicine at Mount Sinai in New York, wrote with colleagues. They added, “Using these classification approaches, patients have marked variability in the rate of progression and response to therapy, and biomarkers that reflect molecular mechanisms underlying the clinical-pathologic diagnoses are needed.”
Researchers evaluated 1,010 patients in the CureGN Cohort to explore the relationship between urine plasmin(ogen) and ESKD. The multicenter trial included patients with biopsy-proven glomerular disease, such as focal segmental glomerulosclerosis, membranous nephropathy and immunoglobulin A nephropathy.
The main predictor and outcome was urine baseline plasminogen and progression to ESKD.
Findings showed adjusted Log2uPlasminogen/cr was significantly linked to ESKD, at a hazard ratio of 1.31. In addition, comparison of the predictive performance of the models including Log2uPlasminogen/cr, Log2 urine protein-creatinine ratio or both showed plasmin model superiority.
The ratio of measured to expected urine plasmin(ogen) was independently tied to ESKD, according to the researchers. Patients with a ratio of below 0.8 had lower risk for ESKD, while those with a ratio above 1.1 had a higher risk vs. those with a ratio from 0.8 to 1.1.
“Urine plasminogen exhibited good performance and, if further validated, could enable risk stratification for timely interventions in ... proteinuria and glomerular disease,” de Cos and researchers wrote. “Taken together with our previous experimental findings, urinary plasmin(ogen) could be a useful biomarker in prognostic decision-making and a target for the development of novel therapies in patients with proteinuria and glomerular disease.”
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