American Journal of Nephrology

Original Report: Laboratory Investigation

Reduced Serum Fetuin-A in Nephrotic Children: A Consequence of Proteinuria?

Fischer D.-C.a, b · Schaible J.b · Wigger M.b · Staude H.b · Drueckler E.b · Kundt G.c · Haffner D.a

Author affiliations

aDepartment of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, and bDepartment of Pediatrics and cInstitute of Medical Informatics and Biometry, University of Rostock, Rostock, Germany

Keywords: Fetuin-ANephrotic syndromeChildrenProteinuriaFractional excretion

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Am J Nephrol 2011;34:373–380
https://doi.org/10.1159/000331061

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Laboratory Investigation

Received: May 27, 2011
Accepted: July 22, 2011
Published online: September 02, 2011
Issue release date: October 2011

Number of Print Pages: 8
Number of Figures: 5
Number of Tables: 3

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

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

Abstract

Background: The extracellular protein fetuin-A is a potent soluble inhibitor of calcification, and its deficiency has been associated with vascular calcification in dialysis patients. In proteinuric patients, significant urinary losses of fetuin-A may cause low serum fetuin-A levels. Methods: In a cross-sectional study, urinary/serum concentrations of fetuin-A were investigated in proteinuric children with glomerular diseases and preserved renal function (n = 58) in comparison to healthy controls (n = 246). Results: Mean fetuin-A serum concentrations were clearly reduced in children with nephrotic syndrome (0.25 ± 0.14 g/l, p < 0.001), slightly reduced in children with large proteinuria (0.39 ± 0.15 g/l, p < 0.05), and comparable to controls in those with mild proteinuria (0.45 ± 0.14 vs. 0.46 ± 0.12 g/l). Fetuin-A was positively correlated with serum protein (r = 0.58), albumin (r = 0.57), and calcium (r = 0.64), but negatively correlated with proteinuria (r = –0.41), albuminuria (r = –0.46), and urinary fetuin-A excretion (r = –0.48; each p < 0.001). The fractional excretion of fetuin-A was significantly associated with the degree of proteinuria and serum fetuin-A levels. However, the urinary loss of fetuin-A and albumin in nephrotic children differed by three orders of magnitude and the mean fractional excretion of fetuin-A was only 1/10 of that of albumin (0.016 ± 0.029 vs. 0.162 ± 0.403%; p < 0.001). Conclusions: Fetuin-A is clearly reduced in children with nephrotic syndrome and associated with the degree of hypoalbuminemia. This is due to urinary fetuin-A loss and/or reduced hepatic synthesis. Persistent fetuin-A deficiency may have an impact on cardiovascular morbidity in nephrotic children.

© 2011 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Report: Laboratory Investigation

Received: May 27, 2011
Accepted: July 22, 2011
Published online: September 02, 2011
Issue release date: October 2011

Number of Print Pages: 8
Number of Figures: 5
Number of Tables: 3

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

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

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2011, Vol.34, No. 4

October 2011

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D.-C.F. and J.S. contributed equally to this study and are both considered as first authors.
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