CD80 and suPAR in patients with minimal change disease and focal segmental glomerulosclerosis: diagnostic and pathogenic significance

Background Minimal change disease (MCD) is characterized by increased urinary excretion of CD80, whereas focal segmental glomerulosclerosis (FSGS) is associated with increased serum soluble urokinase-type plasminogen activator receptor (suPAR). The aim of the study was to assess whether the simultaneous measurement of urinary CD80 and serum suPAR helps differentiate MCD and FSGS. Methods Urine and sera were collected from patients with MCD in relapse or in remission, from FSGS patients with nephrotic syndrome, and from healthy individuals. CD80 and suPAR were measured by ELISA. Results Urinary CD80 was significantly increased in MCD patients in relapse compared with those in remission and with FSGS patients and control individuals. Serum suPAR levels were significantly higher in patients with FSGS when compared with MCD patients in relapse. Urinary suPAR showed a positive correlation with proteinuria in MCD in relapse and FSGS patients, whereas urinary CD80 correlated with proteinuria only in MCD patients in relapse. Conclusion Urinary CD80 is elevated in MCD patients in relapse compared with FSGS patients. In contrast, serum suPAR is significantly elevated in FSGS patients. The consistent pattern of these two biomarkers in MCD and FSGS suggests that these two conditions represent different entities rather than a continuum spectrum of one disease. Keywords CD80 * Minimal change disease * Focal segmental glomerulosclerosis * suPAR * Nephrotic syndrome
Introduction Idiopathic nephrotic syndrome (INS) is defined as the association of nephrotic syndrome with nonspecific glomerular abnormalities, including minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and mesangial proliferative glomerulonephritis [...]