Identifying a potential biomarker for primary focal segmental glomerulosclerosis and its association with recurrence after transplantation

Clin Transplant. 2019 Mar;33(3):e13487. doi: 10.1111/ctr.13487. Epub 2019 Feb 21.


Background: We investigated circulating levels of individual soluble urokinase plasminogen activation receptor (suPAR) forms to determine if specific circulating fragments of suPAR (II-III) and (I) can better serve as clinical biomarkers for focal segmental glomerulosclerosis (FSGS) and the risk of recurrence after transplantation.

Materials and methods: Serum levels of intact suPAR and its cleaved forms were measured with two assays, ELISA and TR-FIA.

Results: suPAR levels in healthy controls were significantly lower than those who had glomerular diseases but were not significantly different between FSGS patients and glomerular controls. Intact suPAR (I-II-III) levels were noted to be elevated in glomerular diseases including FSGS. uPAR fragment (I) levels measured with the TR-FIA 4 assay were significantly higher in FSGS (695.4 + 91.29 pMol/L) than glomerular controls (239.1 + 40.45 pMol/L, P = 0.001). However, suPAR(I) levels were not significantly different between recurrent FSGS and nonrecurrent FSGS patients.

Conclusion: Our analysis of suPAR using the ELISA assay used in all previous studies does not appear to be a useful marker for FSGS nor serve as a predictor for its recurrence after transplantation. The TR-FIA assay results suggest that uPAR(I) is a potential biomarker for FSGS but not of its recurrence.

Keywords: focal segmental glomerulosclerosis; suPAR; suPAR forms; uPAR (I).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Glomerulosclerosis, Focal Segmental / blood
  • Glomerulosclerosis, Focal Segmental / diagnosis*
  • Glomerulosclerosis, Focal Segmental / etiology
  • Graft Rejection / blood
  • Graft Rejection / diagnosis*
  • Graft Rejection / etiology
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Receptors, Urokinase Plasminogen Activator / blood*
  • Recurrence
  • Risk Factors


  • Biomarkers
  • PLAUR protein, human
  • Receptors, Urokinase Plasminogen Activator