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Vol. 26, No. 3, 2006
Issue release date: July 2006
Section title: Original Report: Patient-Oriented Translational Research
Am J Nephrol 2006;26:258–267
(DOI:10.1159/000093814)

Urinary Proteome of Steroid-Sensitive and Steroid-Resistant Idiopathic Nephrotic Syndrome of Childhood

Woroniecki R.P. · Orlova T.N. · Mendelev N. · Shatat I.F. · Hailpern S.M. · Kaskel F.J. · Goligorsky M.S. · O’Riordan E.
aSection of Pediatric Nephrology, Department of Pediatrics, and bDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, N.Y.; cRenal Institute, New York Medical College, Valhalla, N.Y., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented Translational Research

Received: 6/2/2005
Accepted: 3/5/2006
Published online: 7/19/2006

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 4

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN

Abstract

The response to steroid therapy is used to characterize the idiopathic nephrotic syndrome (INS) of childhood as either steroid-sensitive (SSNS) or steroid-resistant (SRNS), a classification with a better prognostic capability than renal biopsy. The majority (∼80%) of INS is due to minimal change disease but the percentage of focal and segmental glomerulosclerosis is increasing. We applied a new technological platform to examine the urine proteome to determine if different urinary protein excretion profiles could differentiate patients with SSNS from those with SRNS. Twenty-five patients with INS and 17 control patients were studied. Mid-stream urines were analyzed using surface enhanced laser desorption and ionization mass spectrometry(SELDI-MS). Data were analyzed using multiple bioinformatic techniques. Patient classification was performed using Biomarker Pattern SoftwareTM and a generalized form of Adaboost and predictive models were generated using a supervised algorithm with cross-validation. Urinary proteomic data distinguished INS patients from control patients, irrespective of steroid response, with a sensitivity of 92.3%, specificity of 93.7%, positive predictive value of 96% and a negative predictive value of 88.2%. Classification of patients as SSNS or SRNS was 100%. A protein of mass 4,144 daltons was identified as the single most important classifier in distinguishing SSNS from SRNS. SELDI-MS combined with bioinformatics can identify different proteomic patterns in INS. Characterization of the proteins of interest identified by this proteomic approach with prospective clinical validation may yield a valuable clinical tool for the non-invasive prediction of treatment response and prognosis.


  

Author Contacts

Dr. Robert P. Woroniecki
Division of Pediatric Nephrology, Department of Pediatrics
Albert Einstein College of Medicine, Children’s Hospital at Montefiore
Bronx, NY 10467 (USA)
Tel. +1 718 655 1120, Fax +1 718 652 3136, E-Mail rworonie@aecom.yu.edu

  

Article Information

Received: February 6, 2006
Accepted: May 3, 2006
Published online: June 7, 2006
Number of Print Pages : 10
Number of Figures : 5, Number of Tables : 4, Number of References : 21

  

Publication Details

American Journal of Nephrology

Vol. 26, No. 3, Year 2006 (Cover Date: July 2006)

Journal Editor: Bakris, G. (Chicago, Ill.)
ISSN: 0250–8095 (print), 1421–9670 (Online)

For additional information: http://www.karger.com/AJN


Article / Publication Details

First-Page Preview
Abstract of Original Report: Patient-Oriented Translational Research

Received: 6/2/2005
Accepted: 3/5/2006
Published online: 7/19/2006

Number of Print Pages: 10
Number of Figures: 5
Number of Tables: 4

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: http://www.karger.com/AJN


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