Document Detail

Urinary procollagen III aminoterminal propeptide (PIIINP): a fibrotest for the nephrologist.
MedLine Citation:
PMID:  20089486     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Kidney biopsy (KB), to date the only tool for the evaluation of renal fibrosis, carries specific risks, and its relevance is limited by the small size of renal parenchyma assessed. Thus, a noninvasive alternative to KB is required. Collagen type III amino-terminal propeptide (PIIINP) is a degradation product of collagen type III, the increase of which may reflect an ongoing fibrotic process.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective study including 199 patients with various stages of chronic kidney disease (CKD), the association between urinary PIIINP/creatinine ratio (UPIIINP/Cr), patients' characteristics, and renal fibrosis was assessed.
RESULTS: A total of 118 of the patients had UPIIINP/Cr measured simultaneously with the performance of a KB. In patients, median UPIIINP/Cr was 290 ng/mmol versus 93.7 ng/mmol in controls. In univariate analysis, UPIIINP/Cr was correlated with serum creatinine, estimated GFR, CKD stage, presence of coronary artery disease, and nephropathy type (glomerulonephritis versus other types). In multivariate analysis, only estimated GFR and nephropathy type were correlated with UPIIINP/Cr. UPIIINP/Cr was closely correlated with the extent of interstitial fibrosis in KB assessed using two different methods. Moreover, UPIIINP/Cr >800 ng/mmol had a negative predictive value of 94% to detect patients in whom KB will eventually prove "noninformative" (KB leading neither to a definite diagnosis of nephropathy nor to specific treatment).
CONCLUSIONS: UPIIINP/Cr is a promising fibro-test for the kidney and may alleviate the need for KB in some patients with CKD. Its predictive value for CKD progression deserves evaluation in prospective studies.
Balsam El Ghoul; Tarek Squalli; Aude Servais; Caroline Elie; Vannary Meas-Yedid; Christine Trivint; Jill Vanmassenhove; Jean-Pierre Grünfeld; Jean-Christophe Olivo-Marin; Eric Thervet; Laure-Hélène Noël; Dominique Prié; Fadi Fakhouri
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Publication Detail:
Type:  Journal Article     Date:  2010-01-14
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-05-07     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-10     Citation Subset:  IM    
Department of Nephrology, Université Paris Descartes, Hôpital Necker, Paris, France.
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MeSH Terms
Biological Markers / blood,  urine
Chronic Disease
Creatinine / blood,  urine
Glomerular Filtration Rate
Kidney / metabolism*,  pathology,  physiopathology
Kidney Diseases / diagnosis*,  pathology,  physiopathology,  urine
Logistic Models
Middle Aged
Peptide Fragments / urine*
Predictive Value of Tests
Procollagen / urine*
Prospective Studies
Sensitivity and Specificity
Severity of Illness Index
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/Procollagen; 0/procollagen Type III-N-terminal peptide; 60-27-5/Creatinine

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