Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins
Background: Transient proteinuria during febrile illness is a common phenomenon. Recent studies have re-examined the pathophysiology of proteinuria and new urinary markers to characterize it, including B7-1 (CD80), which is expressed also in glomerular podocytes and influences the glomerular barrier...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2018-08-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2018.00202/full |
| _version_ | 1818537705514991616 |
|---|---|
| author | Evgenia Gurevich Evgenia Gurevich Eytan Israel Eytan Israel Yael Segev Daniel Landau Daniel Landau |
| author_facet | Evgenia Gurevich Evgenia Gurevich Eytan Israel Eytan Israel Yael Segev Daniel Landau Daniel Landau |
| author_sort | Evgenia Gurevich |
| collection | DOAJ |
| description | Background: Transient proteinuria during febrile illness is a common phenomenon. Recent studies have re-examined the pathophysiology of proteinuria and new urinary markers to characterize it, including B7-1 (CD80), which is expressed also in glomerular podocytes and influences the glomerular barrier.Aim: To investigate the pattern of proteinuria in febrile non-renal diseases, including B7-1.Methods: We prospectively analyzed urine samples of 44 febrile children and 28 afebrile controls for different protein components: albumin (glomerular marker), β2-microglobulin (tubular marker), uromodulin (Tamm Horsfall protein-THP, a renal endogenous protein) and B7-1. Febrile illness was characterized as focal bacterial vs. viral. Exclusion criteria were underlying renal disease, steroid treatment or urinary tract infection.Results: Elevated urine albumin (64.5 ± 10.3 vs. 17.8 ± 4 mg/g, mean ± S.E.M., p = 0.0009) and β2-microglobulin (1.44 ± 0.34 vs. 0.182 ± 0.03 mg/g, mean ± S.E.M., p = 0.005] and decreased uromodulin (10.5 ± 1 vs. 26.7 ± 2.2 Arbitrary units, mean ± S.E.M., p = 0.0001) excretion were found during febrile illness vs. controls. Urine B7-1 was also increased in the febrile group (0.27 ± 0.05 vs. 0.07 ± 0.01 ng/ml, mean ± S.E.M., p = 0.001), and was the only marker which was significantly higher in bacterial vs. viral disease.Conclusions: Febrile proteinuria is not generalized: while proteins of both glomerular and tubular origin increase, uromodulin decreases. Urine B7-1 is increased during fever, more significantly in bacterial infections. Thus, urinary B7-1 may be used as an additional marker to differentiate between febrile states of bacterial vs. viral origin. |
| first_indexed | 2024-12-11T18:54:12Z |
| format | Article |
| id | doaj.art-85216b2cfb064279b9a19d5eb44afe53 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-11T18:54:12Z |
| publishDate | 2018-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-85216b2cfb064279b9a19d5eb44afe532022-12-22T00:54:12ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602018-08-01610.3389/fped.2018.00202318572Febrile Proteinuria in Hospitalized Children: Characterization of Urinary ProteinsEvgenia Gurevich0Evgenia Gurevich1Eytan Israel2Eytan Israel3Yael Segev4Daniel Landau5Daniel Landau6Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, IsraelDivision of Pediatrics, Ben-Gurion University of the Negev, Beersheba, IsraelSoroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, IsraelDivision of Pediatrics, Ben-Gurion University of the Negev, Beersheba, IsraelDepartment of Microbiology and Immunology, Ben-Gurion University of the Negev, Beersheba, IsraelDepartment of Microbiology and Immunology, Ben-Gurion University of the Negev, Beersheba, IsraelDepartment of Pediatrics B, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelBackground: Transient proteinuria during febrile illness is a common phenomenon. Recent studies have re-examined the pathophysiology of proteinuria and new urinary markers to characterize it, including B7-1 (CD80), which is expressed also in glomerular podocytes and influences the glomerular barrier.Aim: To investigate the pattern of proteinuria in febrile non-renal diseases, including B7-1.Methods: We prospectively analyzed urine samples of 44 febrile children and 28 afebrile controls for different protein components: albumin (glomerular marker), β2-microglobulin (tubular marker), uromodulin (Tamm Horsfall protein-THP, a renal endogenous protein) and B7-1. Febrile illness was characterized as focal bacterial vs. viral. Exclusion criteria were underlying renal disease, steroid treatment or urinary tract infection.Results: Elevated urine albumin (64.5 ± 10.3 vs. 17.8 ± 4 mg/g, mean ± S.E.M., p = 0.0009) and β2-microglobulin (1.44 ± 0.34 vs. 0.182 ± 0.03 mg/g, mean ± S.E.M., p = 0.005] and decreased uromodulin (10.5 ± 1 vs. 26.7 ± 2.2 Arbitrary units, mean ± S.E.M., p = 0.0001) excretion were found during febrile illness vs. controls. Urine B7-1 was also increased in the febrile group (0.27 ± 0.05 vs. 0.07 ± 0.01 ng/ml, mean ± S.E.M., p = 0.001), and was the only marker which was significantly higher in bacterial vs. viral disease.Conclusions: Febrile proteinuria is not generalized: while proteins of both glomerular and tubular origin increase, uromodulin decreases. Urine B7-1 is increased during fever, more significantly in bacterial infections. Thus, urinary B7-1 may be used as an additional marker to differentiate between febrile states of bacterial vs. viral origin.https://www.frontiersin.org/article/10.3389/fped.2018.00202/fullβ2-microglobulinuromodulinCD80 (B7-1) proteinalbuminuriaproteinuriafever |
| spellingShingle | Evgenia Gurevich Evgenia Gurevich Eytan Israel Eytan Israel Yael Segev Daniel Landau Daniel Landau Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins Frontiers in Pediatrics β2-microglobulin uromodulin CD80 (B7-1) protein albuminuria proteinuria fever |
| title | Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins |
| title_full | Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins |
| title_fullStr | Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins |
| title_full_unstemmed | Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins |
| title_short | Febrile Proteinuria in Hospitalized Children: Characterization of Urinary Proteins |
| title_sort | febrile proteinuria in hospitalized children characterization of urinary proteins |
| topic | β2-microglobulin uromodulin CD80 (B7-1) protein albuminuria proteinuria fever |
| url | https://www.frontiersin.org/article/10.3389/fped.2018.00202/full |
| work_keys_str_mv | AT evgeniagurevich febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT evgeniagurevich febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT eytanisrael febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT eytanisrael febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT yaelsegev febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT daniellandau febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins AT daniellandau febrileproteinuriainhospitalizedchildrencharacterizationofurinaryproteins |