title: Management of severe recurrent focal segmental glomerulosclerosis through circulating soluble urokinase receptor modification.
abstract: Circulating soluble urokinase receptor (suPAR) was recently identified as one of the causes responsible for native and recurrent focal segmental glomerulosclerosis (FSGS) through overactivation of podocyte β(3) integrin. Here, we discuss the management of a patient with very high suPAR serum levels and FSGS recurrence. The suPAR reduction using plasmapheresis and immunoadsorption allowed for lowering of suPAR and reduced podocyte β(3) integrin activation and proteinuria. The patient is successfully weaned to bimonthly suPAR removal treatments with improved renal parameters. In summary, we provide an approach for the successful management of severe recurrent FSGS using available therapies with biomarker guidance.
authors: Department of Medicine, Division of Nephrology, University of Heidelberg, Heidelberg, Germany. christian.morath@med.uni-heidelberg.de
authors: Christian
authors: C
authors: Morath
authors: Changli
authors: C
authors: Wei
authors: Stephan
authors: S
authors: Macher-Goeppinger
authors: Vedat
authors: V
authors: Schwenger
authors: Martin
authors: M
authors: Zeier
authors: Jochen
authors: J
authors: Reiser
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007163:Immunosorbent Techniques; D039661:Integrin beta3 / Q000378:metabolism; D008875:Middle Aged; D010956:Plasmapheresis / Q000379:methods*; D050199:Podocytes / Q000378:metabolism; D011507:Proteinuria / Q000209:etiology / Q000628:therapy; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D039661:Integrin beta3; D055293:Receptors, Urokinase Plasminogen Activator