A study done recently looked at suPAR levels in adults and pediatric patients with FSGS of two cohorts - the FSGS CT and PodoNet Cohort. Compared to controls, they were elevated in 83% and 55% in two respective cohorts. Interestingly, MMF treated was associated with lower levels as compared to cyclosporine. In addition, it appears that the ones that had lower levels had more likely chance of remission.
Why did one group of cohorts have a higher suPAR relationship compared to other? The mean serum creatinine was significantly higher in patients enrolled in the FSGS CT cohort than the PodoNet cohort and the authors suggest that this might be the reason for the difference. The entire article is an interesting read.
The take home points are:
1. The circulating suPAR levels were markedly elevated in the majority of patients with primary FSGS in two distinct cohorts including children and adults
2. When evaluated with CRP levels, it was not due to inflammation that the suPAR was elevated.
3. MMF therapy was associated with a lower serum level of suPAR;
4. A decline in suPAR levels that was sustained over the course of 26 weeks of treatment was associated with decreased in proteinuria and remission
5. Serum suPAR levels were higher in familial cases including those with a defined podocin mutation.
6. Female patients had higher suPAR levels in both cohorts- unclear why.
Anti suPAR drugs should be great agents if this association continues to hold with FSGS??
Check out the full article in JASN
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