Nephrology Dialysis Transplantation, Vol 12, Issue 9 1883-1889, Copyright © 1997 by Oxford University Press
O Soylemezoglu, G Wild, A Dalley, S MacNeil, A Milford-Ward, C Brown and A El Nahas
Background. The progression of chronic renal failure
is characterized by the progressive fibrosis of the kidneys. Such fibrosis
reflects the increased deposition of collagens (I, III, and IV) as well as
fibronectin within scarred kidneys. In this study, we determined whether
changes in renal extracellular matrix (ECM) components are reflected by
parallel changes in their circulating or urinary levels. Patients
and methods. We studied 40 patients with a range of subacute and
chronic nephropathies who underwent a renal biopsy. At the time of the
biopsy, their serum and urinary levels of collagens III (amino terminal
peptide of procollagen III; PIIINP) and IV, as well as fibronectin were
measured. Clinical, biochemical and histological parameters were
correlated. Multiple regression analysis was applied to determine the
predictive value of circulating and urinary ECM components for the severity
of renal fibrosis. Results. We noted an increase in
circulating and urinary levels of collagens III and IV but not fibronectin
in patients with nephropathies compared to healthy volunteers. Increased
immunoreactivity for these ECM components was also detected in kidney
biopsies when compared to normal kidneys. A strong positive correlation was
detected between circulating and urinary procollagen III (PIIINP) and the
severity of renal interstitial fibrosis (serum PIINP: r=0.49,
P<l0.01; urine PIINP: r=0.51, P<0.01).
Conclusions. We conclude that the measurements of
urinary collagen III (PIINP), and to a lesser extent serum collagen III
(PIIINP), are useful indicators of the extent of renal fibrosis. This may
have diagnostic implications and may prove useful for the monitoring of
disease progression. Keywords: renal fibrosis;
collagen III; collagen IV; fibronectin
ORIGINAL ARTICLES
Urinary and serum type II collagen: markers of renal fibrosis
Sheffield Kidney Institute, Departments of Immunology and Medicine, Northern General Hospital Trust, Herries Road, Sheffield S5 7AU, UK; Corresponding author
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