mRNA expression of target genes in the urinary sediment as a noninvasive prognostic indicator of CKD.
BACKGROUND
Study of messenger RNA (mRNA) expression of target genes in urinary sediment was suggested as a noninvasive marker of renal damage in patients with chronic kidney diseases (CKDs). We studied the relationship between urinary mRNA expression of target genes and risk for renal function deterioration in patients with CKD.


METHODS
We studied 131 patients with CKD with kidney biopsy. mRNA expression of 11 target genes in urinary sediment was measured by means of quantitative polymerase chain reaction. Patients then were followed up for 27.4 +/- 10.1 months. The primary end point is doubling of serum creatinine concentration or end-stage renal disease.


RESULTS
Thirty-six patients (27.5%) reached the primary end point during follow-up. Univariate analysis showed that sex, age, proteinuria, estimated glomerular filtration rate, histological diagnosis, degree of tubulointerstitial scarring, percentage of glomerulosclerosis, and urinary mRNA expression of hepatocyte growth factor (HGF) were predictors of the primary end point. At 24 months, event-free survival rates were 90.9% and 64.3% for patients with low and high urinary HGF expression, respectively (log rank test, P = 0.002). After adjusting for other confounding factors by using a Cox proportional hazard model, urinary HGF expression remained an independent predictor of the primary end point, and a 1-fold increase in expression was associated with a 4.0% (95% confidence interval, 0.5 to 7.5; P = 0.024) increase in risk.


CONCLUSIONS
In the target genes examined, urinary HGF expression is an independent prognostic indicator of CKD after adjusting for confounding clinical and histological factors. Measurement of urinary HGF mRNA expression may be a useful noninvasive tool for risk stratification of patients with CKD.
Department of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China. ccszeto@cuhk.edu.hk
Cheuk-Chun
CC
Szeto
Kai-Ming
KM
Chow
Ka-Bik
KB
Lai
Carol Yi-Ki
CY
Szeto
Rebecca Wing-Yan
RW
Chan
Bonnie Ching-Ha
BC
Kwan
Kwok-Yi
KY
Chung
Philip Kam-Tao
PK
Li
Fernand Mac-Moune
FM
Lai
D001706:Biopsy; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000235:genetics* / Q000473:pathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012333:RNA, Messenger / Q000096:biosynthesis* / Q000652:urine; D012307:Risk Factors
D012333:RNA, Messenger