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.
Funding: Seoul National University Bundang Hospital Research Fund
[grant number 06-2019-198].
Keywords: preeclampsia, proteinuria, nephrin, biomarker,
preterm birth