TY - JOUR
T1 - Urinary podocalyxin as a biomarker to diagnose membranous nephropathy
AU - Imaizumi, Takahiro
AU - Nakatochi, Masahiro
AU - Akiyama, Shin'ichi
AU - Yamaguchi, Makoto
AU - Kurosawa, Hiroyuki
AU - Hirayama, Yoshiaki
AU - Katsuno, Takayuki
AU - Tsuboi, Naotake
AU - Hara, Masanori
AU - Maruyama, Shoichi
N1 - Funding Information:
Two authors [HK, YH] are employed by Denka Co., Ltd. The Department of Nephrology, Nagoya University Graduate School of Medicine, received research promotion grants from Astellas, Alexion, Otsuka, Kyowa Hakko Kirin, Daiichi Sankyo, Dainippon Sumitomo, Takeda, Torii, Pfizer, and Mochida. The Center for Advanced Medicine and Clinical Reseach, Nagoya University Hospital received a donation from Pfizer. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Publisher Copyright:
Copyright © 2016 Imaizumi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/9
Y1 - 2016/9
N2 - Background: A non-invasive diagnostic marker of membranous nephropathy (MN) is desirable. The urinary level of podocalyxin (PCX) is higher in various glomerular diseases, including MN. The aim of this study was to construct a diagnostic model of MN with the combination of urinary PCX and clinical parameters. Methods: We performed this cross-sectional study to construct the diagnostic models for MN by using data and samples from the multicenter kidney biopsy registry of Nagoya University and its affiliated hospitals. Urinary (u-) PCX was measured by sandwich ELISA. We constructed 3 types of diagnostic models in 105 training samples: u-PCX univariate model, the combined model of clinical parameters other than u-PCX (clinical model), and the combined model of both u-PCX and clinical parameters (combined model). We assessed the clinical usefulness of the diagnostic models through the comparison of c-statistics and decision curve analysis (DCA) in 209 validation samples. Results: The clinical model consisted of age, glomerular filtration rate, and diabetes mellitus. In the training cohort, the c-statistics were 0.868 [95% CI, 0.799-0.937] in the combined model. In the validation cohort, sensitivity was 80.5% and specificity was 73.5% on the cut-off value. The net benefit of the combined model was better between threshold probabilities of 40-80% in DCA. Conclusions: In this study, we demonstrated the utility of u-PCX as a diagnostic marker for MN and the clinical usefulness of the diagnostic models, through the combination of u-PCX and clinical parameters including age, glomerular filtration rate, and diabetes mellitus.
AB - Background: A non-invasive diagnostic marker of membranous nephropathy (MN) is desirable. The urinary level of podocalyxin (PCX) is higher in various glomerular diseases, including MN. The aim of this study was to construct a diagnostic model of MN with the combination of urinary PCX and clinical parameters. Methods: We performed this cross-sectional study to construct the diagnostic models for MN by using data and samples from the multicenter kidney biopsy registry of Nagoya University and its affiliated hospitals. Urinary (u-) PCX was measured by sandwich ELISA. We constructed 3 types of diagnostic models in 105 training samples: u-PCX univariate model, the combined model of clinical parameters other than u-PCX (clinical model), and the combined model of both u-PCX and clinical parameters (combined model). We assessed the clinical usefulness of the diagnostic models through the comparison of c-statistics and decision curve analysis (DCA) in 209 validation samples. Results: The clinical model consisted of age, glomerular filtration rate, and diabetes mellitus. In the training cohort, the c-statistics were 0.868 [95% CI, 0.799-0.937] in the combined model. In the validation cohort, sensitivity was 80.5% and specificity was 73.5% on the cut-off value. The net benefit of the combined model was better between threshold probabilities of 40-80% in DCA. Conclusions: In this study, we demonstrated the utility of u-PCX as a diagnostic marker for MN and the clinical usefulness of the diagnostic models, through the combination of u-PCX and clinical parameters including age, glomerular filtration rate, and diabetes mellitus.
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U2 - 10.1371/journal.pone.0163507
DO - 10.1371/journal.pone.0163507
M3 - Article
AN - SCOPUS:84992432112
VL - 11
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 9
M1 - e0163507
ER -