Nephrin in maternal urine applied to a point-of-care kit to predict
preeclampsia: a prospective study.
Abstract
Objective: Nephrin is a protein in the glomerular podocyte slit
diaphragm; therefore, its presence in urine implies damage to podocytes.
This study aimed to determine the efficacy of nephrin as a biomarker in
maternal urine to predict preeclampsia (PE). Design and setting: This
prospective study included pregnant women admitted for delivery at Seoul
National University Bundang Hospital: March 2019 – May 2020.
Population: Patients who had been diagnosed with PE were included and
patients without a history of underlying diseases were recruited for the
control group. Important clinical data has been collected. Methods:
Urine samples were obtained, and nephrin signaling was detected through
test strips using a lateral flow assay. Main Outcome Measures: The
results of the point-of-care test were compared between the 2 groups:
patients with PE, and without (control group) using the exact
concentration of nephrin by enzyme-linked immunosorbent assay (ELISA).
Results: Clinical characteristics – maternal age, rate of nulliparity,
proportion of twin pregnancies, height, weight, cesarean section rate –
were comparable between the PE and control groups. Nephrin signals were
classified into four groups. In the PE group, signals 0, 1, 2, and 3
were found in 18.4% (9/49), 44.9% (22/49), 24.5% (12/49), and 12.2%
(6/49) of participants, respectively. This was significantly different
from the control group, in which 84.3% (43/51) were found to have
signal 0 (P<0.001). Conclusions: Nephrin signaling in maternal
urine could be a noninvasive and useful test for predetecting severity
of PE.