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Uromodulin and α1-antitrypsin urinary peptide analysis to differentiate glomerular kidney diseases

AuthorsNavarro-Muñoz, M.; Casado-Vela, Juan; Romero, Ramón
Issue Date2012
PublisherS. Karger AG
CitationKidney and Blood Pressure Research 35(5): 314325 (2012)
Abstract[Background/Aims]: Glomerular kidney disease (GKD) is suspected in patients based on proteinuria, but its diagnosis relies primarily on renal biopsy. We used urine peptide profiling as a noninvasive means to link GKD-associated changes to each glomerular entity. [Methods]: Urinary peptide profiles of 60 biopsy-proven glomerular patients and 14 controls were analyzed by combining magnetic bead peptide enrichment, MALDI-TOF MS analysis, and ClinProTools v2.0 to select differential peptides. Tentative identification of the differential peptides was carried out by HPLC-MS/MS. [Results]: The HPLC-MS/MS results suggest that uromodulin (UMOD; m/z: 1682, 1898 and 1913) and α 1- antitrypsin (A1AT; m/z: 1945, 2392 and 2505) are differentially expressed urinary peptides that distinguish between GKD patients and healthy subjects. Low UMOD and high A1AT peptide abundance was observed in 80-92% of patients with GKD. Proliferative forms of GKD were distinguished from nonproliferative forms, based on a combination of UMOD and A1AT peptides. Nonproliferative forms correlated with higher A1AT peptide levels - focal segmental glomerulosclerosis was linked more closely to high levels of the m/z 1945 peptide than minimal change disease. [Conclusion]: We describe a workflow - urinary peptide profiling coupled with histological findings - that can be used to distinguish GKD accurately and noninvasively, particularly its nonproliferative forms. Copyright © 2012 S. Karger AG.
Identifiersdoi: 10.1159/000335383
issn: 1420-4096
e-issn: 1423-0143
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