Urinary fatty acid-binding protein as a new clinical marker of the progression of chronic renal disease

J Lab Clin Med. 2004 Jan;143(1):23-30. doi: 10.1016/j.lab.2003.08.001.


Previous studies have indicated that in massive proteinuria, free fatty acids (FFAs) bound to albumin were overloaded in the proximal tubule and exacerbated tubulointerstitial damage. Liver-type fatty acid-binding protein (L-FABP) is an intracellular carrier protein of FFAs that is expressed in the proximal tubule of human kidney. We sought to evaluate urinary L-FABP as a clinical marker in chronic renal disease. Urinary L-FABP was measured in patients with nondiabetic chronic renal disease (n = 120) with the use of a newly established ELISA method. We then monitored these patients for 15 to 51 months. Clinical data were analyzed with multivariate analysis. Urinary L-FABP was correlated with urinary protein, urinary alpha(1)-microglobulin, and serum creatinine concentrations. Urinary L-FABP at the start of follow-up (F = 17.1, r =.36, P <.0001) was selected as a significant clinical factor correlated with the progression rate, defined as a slope of a reciprocal of serum creatinine over time. We next selected the patients with mild renal dysfunction (n = 35) from all 120 patients and divided them into 2 groups according to progression rate: the progression group (n = 22) and the nonprogression group (n = 13). Serum creatinine and urinary protein concentrations and blood pressure at the start of follow-up were higher in the progression group than in the nonprogression group, although we detected no significant difference between the 2 groups. Urinary L-FABP was significantly higher in the former group than in the latter (P <.05). The results showed that urinary L-FABP reflected the clinical prognosis of chronic renal disease. Urinary L-FABP may be a clinical marker that can help predict the progression of chronic glomerular disease.

MeSH terms

  • Animals
  • Antibodies, Monoclonal / biosynthesis
  • Biomarkers / urine*
  • Biopsy
  • Carrier Proteins / immunology
  • Carrier Proteins / urine*
  • Creatinine / blood
  • Disease Progression
  • Enzyme-Linked Immunosorbent Assay
  • Fatty Acid-Binding Protein 7
  • Fatty Acid-Binding Proteins
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / pathology
  • Kidney Failure, Chronic / urine*
  • Liver / metabolism
  • Male
  • Membrane Glycoproteins / urine
  • Mice
  • Mice, Inbred BALB C
  • Middle Aged
  • Neoplasm Proteins*
  • Nerve Tissue Proteins*
  • Proteinuria
  • Trypsin Inhibitor, Kunitz Soybean / urine
  • Tumor Suppressor Proteins*


  • Antibodies, Monoclonal
  • Biomarkers
  • Carrier Proteins
  • FABP1 protein, human
  • FABP7 protein, human
  • Fabp1 protein, mouse
  • Fabp5 protein, mouse
  • Fabp7 protein, mouse
  • Fatty Acid-Binding Protein 7
  • Fatty Acid-Binding Proteins
  • Membrane Glycoproteins
  • Neoplasm Proteins
  • Nerve Tissue Proteins
  • SPINT2 protein, human
  • Tumor Suppressor Proteins
  • Trypsin Inhibitor, Kunitz Soybean
  • Creatinine