title: Urinary uromodulin excretion predicts progression of chronic kidney disease resulting from IgA nephropathy.
abstract: BACKGROUND
  Uromodulin, or Tamm-Horsfall protein, is the most abundant urinary protein in healthy individuals. Recent studies have suggested that uromodulin may play a role in chronic kidney diseases. We examined an IgA nephropathy cohort to determine whether uromodulin plays a role in the progression of IgA nephropathy.
  
  
  METHODS
  A total of 344 IgA nephropathy patients were involved in this study. Morphological changes were evaluated with the Oxford classification of IgA nephropathy. Enzyme Linked Immunosorbent Assay (ELISA) measured the urinary uromodulin level on the renal biopsy day. Follow up was done regularly on 185 patients. Time-average blood pressure, time-average proteinuria, estimated glomerular filtration rate (eGFR) and eGFR decline rate were caculated. Association between the urinary uromodulin level and the eGFR decline rate was analyzed with SPSS 13.0.
  
  
  RESULTS
  We found that lower baseline urinary uromodulin levels (P = 0.03) and higher time-average proteinuria (P = 0.04) were risk factors for rapid eGFR decline in a follow-up subgroup of the IgA nephropathy cohort. Urinary uromodulin level was correlated with tubulointerstitial lesions (P = 0.016). Patients that had more tubular atrophy/interstitial fibrosis on the surface had lower urinary uromodulin levels (P = 0.02).
  
  
  CONCLUSIONS
  Urinary uromodulin level is associated with interstitial fibrosis/tubular atrophy and contributes to eGFR decline in IgA nephropathy.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Zhou
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.forename: Sufang
authors.initials: S
authors.lastname: Shi
authors.forename: Suxia
authors.initials: S
authors.lastname: Wang
authors.forename: Xueying
authors.initials: X
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015331:Cohort Studies; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005355:Fibrosis; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000652:urine*; D006801:Humans; D007249:Inflammation; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011507:Proteinuria / Q000175:diagnosis / Q000652:urine; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000652:urine*; D012307:Risk Factors; D058949:Uromodulin / Q000652:urine*
chemical_list: D058949:Uromodulin