Urinary monocyte chemoattractant protein-1 excretion in children with glomerular proteinuria

OBJECTIVE: The aim of the study was to examine the urinary levels and clinical significance of monocyte chemoattractant protein-1 (uMCP-1) in children according to histological diagnosis and degree of proteinuria. MATERIAL AND METHODS: Group I comprised 20 children with idiopathic nephrotic syndrome (INS), examined twice (A, during INS relapse; and B, after proteinuria subsided). Group II comprised 17 children with persistent proteinuria due to focal segmental glomerulosclerosis (FSGS). Group III included 12 children with immunoglobulin A nephropathy (IgAN). The control group (C) contained 22 healthy children. uMCP-1 was determined by enzyme-linked immunosorbent assay and expressed in pg/ml. RESULTS: The median uMCP-1/creatinine ratio (uMCP-1/cr) in children with minimal change disease in relapse (IA) was significantly higher than in controls (p < 0.05), but when controlling for cyclosporine A (CsA) treatment the median uMCP-1 in children with INS, who were not treated with CsA, was 12.01 pg/mg cr (range 1.82-261.56 pg/mg cr) and did not differ from healthy controls. In examination IB the uMCP-1/cr concentration decreased and did not differ from healthy controls (p > 0.05). Children from groups II and III also had higher uMCP-1/cr levels than groups I and C (p < 0.01). uMCP-1/cr positively correlated with serum total cholesterol, low-density lipoprotein and protein/creatinine ratio in relapse (IA), and with serum cholesterol level in group B. A positive correlation between uMCP-1/cr and protein/creatinine ratio was also confirmed in groups II and III. CONCLUSION: Increased uMCP-1 was found in children with IgAN and FSGS correlated with proteinuria. A slight increase in uMCP-1 in children with INS was probably associated with CsA treatment.