Abstract:

Ｏｂｊｅｃｔｉｖｅ： To investigate the association between urinary microRNA196a (miR196a) and longterm outcome in patients with focal segmental glomerulosclerosis(FSGS).
Ｍｅｔｈｏｄｏｌｏｇｙ：Urinary and plasma miR196a were tested in patients with active FSGS(FSGSA), FSGS in complete remission(FSGSCR) and normal controls(NC) 231 FSGS patients were then enrolled at the time of renal biopsy and urinary miR196a levels were measured by qRTPCR. The relationship between urinary miR196a and longterm outcome of FSGS was analyzed.
Ｒｅｓｕｌｔｓ：Urinary miR196a levels were significantly increased in FSGSA patients as compared with FSGSCR patients and NCs(P<0001). However, plasma miR196a levels showed no difference among the three groups, suggesting that the change of urinary miR196a was mainly kidney derived. Of the 231 patients, 43 patients developed endstage renal disease(ESRD) during the followup period. Urinary miR196a levels were significantly higher in patients who progressed to ESRD than those not progressed to ESRD(P=0025). Urinary miR196a was associated with proteinuria, eGFR, and interstitial fibrosis. Patients with higher urinary miR196a levels had a higher cumulative incidence of ESRD. Risk persisted after adjusting for age, sex, proteinuria, and eGFR.
Ｃｏｎｃｌｕｓｉｏｎ：Urinary miR196a is an independent risk factor of ESRD, facilitating early identification of those who will subsequently develop ESRD.