title: Serum suPAR levels help differentiate steroid resistance from steroid-sensitive nephrotic syndrome in children.
abstract: BACKGROUND
  Soluble urokinase plasminogen activator receptor (suPAR) has been regarded as a permeability factor in proteinuria, though its role in primary nephrotic syndrome remains to be elucidated further.
  
  
  METHODS
  Plasma samples and clinical information from 176 children with primary nephrotic syndrome were collected and concentrations of suPAR were measured. We evaluated the correlation between suPAR concentrations and clinical features, and the value of the plasma suPAR level in predicting steroid-resistant nephrotic syndrome (SRNS).
  
  
  RESULTS
  There is a significant difference in plasma suPAR concentration between SRNS and steroid-sensitive nephrotic syndrome (SSNS) groups (3,744.1 ± 2,226.0 vs. 2,153.5 ± 1,167.0, p < 0.05). The area under the curve (AUC) was 0.80, with p < 0.001 for the receiver operating characteristic (ROC) curve analysis using suPAR to predict SRNS. The suspicious range for predicting SRNS was estimated to be 1,907.0 pg/ml to 3,043.5 pg/ml (χ(2) = 14.775, p = 0.001).
  
  
  CONCLUSIONS
  From ROC curve analysis, we demonstrated the significance of the suPAR level in predicting SRNS with a high specificity but low sensitivity. However, the clinical value of suPAR to predict steroid resistance and guide therapy remains to be investigated further.
authors.affiliation: Department of Nephrology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, China.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Peng
authors.forename: Jianhua
authors.initials: J
authors.lastname: Mao
authors.forename: Xuejun
authors.initials: X
authors.lastname: Chen
authors.forename: Fengqing
authors.initials: F
authors.lastname: Cai
authors.forename: Weizhong
authors.initials: W
authors.lastname: Gu
authors.forename: Haidong
authors.initials: H
authors.lastname: Fu
authors.forename: Huijun
authors.initials: H
authors.lastname: Shen
authors.forename: Jingjing
authors.initials: J
authors.lastname: Wang
authors.forename: Xia
authors.initials: X
authors.lastname: Jin
authors.forename: Xiujuan
authors.initials: X
authors.lastname: Zhu
authors.forename: Aimin
authors.initials: A
authors.lastname: Liu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Shu
authors.forename: Lizhong
authors.initials: L
authors.lastname: Du
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D017668:Age of Onset; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance / Q000502:physiology; D005260:Female; D006801:Humans; D007118:Immunoassay; D007223:Infant; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood* / Q000188:drug therapy*; D012372:ROC Curve; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D055293:Receptors, Urokinase Plasminogen Activator