Clinical and experimental nephrology · 2026
Urinary thrombin as a non-invasive biomarker in renal diseases: a possible role in the detection of segmental sclerosis lesions in IgA nephropathy.
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Miyasato Yoshikazu, Nakagawa Terumasa, Iwata Yasunobu, Kakizoe Yutaka, Izumi Yuichiro, Nagayoshi Yu, Nishiguchi Kayo, Nakagawa Miyuki, Mukoyama Masashi, Yokoi Hideki, Kitamoto Yasunori, Adachi Masataka
Аннотация
BACKGROUND: Thrombin is a serine protease that plays an important role in blood coagulation and has been implicated in kidney diseases, particularly glomerular disorders. In this study, we aimed to evaluate urinary thrombin in different types of kidney disease and investigate whether it can be used as a biomarker for the presence of segmental sclerosis lesions in IgA nephropathy.
METHODS: We enrolled 151 patients aged ≥ 18 years who underwent renal biopsy at Kumamoto University Hospital or two of its affiliate hospitals between November 2016 and September 2021. Urine samples were obtained from patients, and urinary thrombin antigen levels were measured using a previously established highly sensitive enzyme-linked immunosorbent assay. We evaluated urinary thrombin in different types of kidney disease, focusing on IgA nephropathy, and assessed the association between urinary thrombin and histological severity classification (Oxford classification), especially S lesions.
RESULTS: Among the patients with kidney disease, thrombinuria was more prevalent in those with focal segmental glomerulosclerosis [60%; 9/15]. In 34 patients with IgA nephropathy, the logistic regression model, using the presence of S lesions as the outcome variable, demonstrated that the odds ratios for thrombinuria and proteinuria were 7.20 and 2.82, respectively. The areas under the receiver operating characteristic curve (AUROC) regarding the models for thrombinuria and proteinuria were 0.73 and 0.56, respectively, with both differences being significant (p = 0.04).
CONCLUSIONS: Our findings suggest that thrombinuria may be a novel biomarker for kidney disease, particularly for segmental sclerosis lesions in IgA nephropathy.
METHODS: We enrolled 151 patients aged ≥ 18 years who underwent renal biopsy at Kumamoto University Hospital or two of its affiliate hospitals between November 2016 and September 2021. Urine samples were obtained from patients, and urinary thrombin antigen levels were measured using a previously established highly sensitive enzyme-linked immunosorbent assay. We evaluated urinary thrombin in different types of kidney disease, focusing on IgA nephropathy, and assessed the association between urinary thrombin and histological severity classification (Oxford classification), especially S lesions.
RESULTS: Among the patients with kidney disease, thrombinuria was more prevalent in those with focal segmental glomerulosclerosis [60%; 9/15]. In 34 patients with IgA nephropathy, the logistic regression model, using the presence of S lesions as the outcome variable, demonstrated that the odds ratios for thrombinuria and proteinuria were 7.20 and 2.82, respectively. The areas under the receiver operating characteristic curve (AUROC) regarding the models for thrombinuria and proteinuria were 0.73 and 0.56, respectively, with both differences being significant (p = 0.04).
CONCLUSIONS: Our findings suggest that thrombinuria may be a novel biomarker for kidney disease, particularly for segmental sclerosis lesions in IgA nephropathy.