The following is a summary of “Role of baseline soluble tumor necrosis factor receptor 2 as a biomarker in primary podocytopathy: Implications for renal impairment and disease progression,” published in the October 2024 issue of Nephrology by Nagaram et al.
Podocytopathies like minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) damage kidneys and cause heavy proteinuria. Elevated tumor necrosis factor-alpha receptor 2 (TNFR2) levels are linked to worsening renal function in chronic kidney disease (CKD).
Researchers conducted a retrospective study to evaluate the role of elevated TNFR2 levels as biomarkers for renal impairment and disease progression in patients with podocytopathies.
They studied 53 patients with biopsy-proven MCD or FSGS and 53 healthy controls over 18 months. Serum and urine TNFR2 levels and gene expression were analyzed at baseline and after 3 months. Cox regression analysis assessed TNFR2’s ability to predict persistent decline in estimated glomerular filtration rate (eGFR < 30 mL/min/1.73m2), remission, and relapse, while ROC curve analysis evaluated its prognostic utility for progression to stage 4 CKD.
The results showed that serum and urine TNFR2 levels were significantly elevated in patients compared to controls. Serum TNFR2 predicted persistent eGFR decline (HR 1.017, P = 0.018), remission (HR 0.995, P = 0.006), and relapse (HR 1.005, P = 0.029). The ROC curve analysis indicated strong prognostic ability for progression to stage 4 CKD, with an area under the curve (AUC) of 0.848 (95% CI: 0.737—0.960), sensitivity of 81%, and specificity of 71%.
The study concluded that elevated circulating TNFR2 levels are significant predictors of kidney injury, persistent eGFR decline, and disease relapse in primary podocytopathy, highlighting their potential as biomarkers for disease progression.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03772-y#Abs1