Background/Aims: Fibronectin (FN) is one of the major matrix proteins in the kidney. The accumulation of FN fragments in inflamed glomeruli could contribute to the progression of renal injury. In the present study, the urinary FN excretion (UFN) was measured for evaluation of its possible role as a prognostic marker in patients with newly diagnosed chronic glomerulonephritis (GN). Methods: In 55 patients with newly diagnosed biopsy-proven chronic GN, UFN was measured using an enzyme-immunossay kit. The progression of kidney disease was defined as a reduction of the estimated glomerular filtration rate (eGFR) ≧5 ml/min/year during the 4-year follow-up. Results: The mean UFN in patients with GN (245.0 ± 229.2 ng/mmol creatinine) was higher than in the 19 healthy subjects (100.7 ± 87.3 ng/mmol creatinine; p < 0.002). No correlations between the initial UFN and eGFR and proteinuria were found. We did not find any association between UFN and the severity of glomerular sclerosis or the intensity of interstitial fibrosis. The progressive fall of eGFR was recorded in 13 patients (progressors). The mean initial UFN was significantly higher in progressors than in nonprogressors (p < 0.01). In logistic regression analysis, the initial high UFN was identified as independent factor predicting kidney function deterioration. Conclusion: These results indicate that UFN measured before treatment could serve as an additional prognostic marker of a poor outcome in patients with newly diagnosed primary GN.

Mosher DF, Furcht LT: Fibronectin: review of its structure and possible functions. J Invest Dermatol 1981;2:175–180.
Shui HA, Ka SM, Lin JC, Lee JH, Jin JS, Lin JF, et al: Fibronectin in blood invokes the development of focal segmental glomerulosclerosis in mouse model. Nephrol Dial Transpl 2006;21:1794–1802.
Fogo AB: Mechanisms of progression of chronic kidney disease. Pediatr Nephrol 2007;22:2011–2022.
Bergijk EC, Munaut C, Baelde JJ, Prons F, Foidart JM, Hoedemaeker PJ, Bruijn JA: A histologic study of the extracellular matrix during the development of glomerulosclerosis in murine chronic graft-versus-host disease. Am J Pathol 1992;140:1147–1156.
Manabe N, Konoshita A, Yamaguchi M, Furuya Y, Nagano N, Yamada-Uchio K, et al: Changes in quantitative profile of extracellular matrix components in the kidneys of rats with Adriamycin-induced nephropathy. J Vet Med Sci 2001;63:125–133.
Dixon FJ, Burns J, Dunnill MS, McGee J: Distribution of fibronectin in normal and diseased human kidneys. J Clin Pathol 1980;33:1021–1028.
Rosemblum ND: The mesangial matrix in the normal and sclerotic glomerulus. Kidney Int 1994;45:S73–S77.
Vleming LJ, Baelde JJ, Westendorp RG, Daha MR, van Es LA, Bruijn JA: The glomerular deposition of PAS positive material correlates with renal function in human kidney disease. Clin Nephrol 1997;47:158–167.
Nakapoulou I, Stefanaki K. Zeis PM, Papadakis J, Boletis J, Vosnidis G, et al: The glomerular distribution of laminine and fibronectin in glomerulonephritis. Histol Histopathol 1993;8:521–526.
Altunkova I, Minkova V, Belovezhdov N: Role of fibronectin in immune glomerulonephritis. Nephron 1993;63:438–444.
Soose M, Gwinner W, Grotkamp J, Hansemann W, Stolte H: Altered renal fibronectin excretion in early adriamycin nephrosis of rats. J Pharmacol Exp Ther 1991;257:493–499.
Nishizawa Y, Fukai F, Natori Y, Katayama T: Characterization of fibronectin-related substances in normal and passive Heymann nephritis in rats. Biol Pharm Bull 1998;21:429–433.
Lopez-Armada MJ, Gonzalez E, Gomez-Guerrero C, Egido J: The 80-kD fibronectin fragments increases the production of fibronectin and tumor necrosis factor-alpha (TNF-α) in cultured mesangial cells. Clin Exp Immunol 1997;107:398–403.
Roszkowska-Blaim M, Mizerska-Wasiak M, Bartłomiejczyk I: Urinary fibronectin excretion as a marker of disease activity in children with IgA nephropathy and Henoch-Schonlein nephropathy (in Polish). Przegl Lek 2006;63:S90–S93.
Kozlovskaia IV, Bobkova IN, Varshavskiĭ VA, Proskurneva EP, Miroshnichenko NG, Chebotareva NV, Mukhin NA: Urinary fibronectin as an indicator of kidney fibrosis in nephritis (in Russian). Ter Arkh 1999;71:34–38
Shikata K, Makino H, Morioka S, Kashitani T, Hirata K, Oto Z, et al: Distribution of extracellular matrix receptors in various forms of glomerulonephritis. Am J Kidney Dis 1995;25:680–688.
Kanauchi M, Nishioka H, Dohi K: Diagnostic significance of urinary fibronectin in diabetic nephropathy. Nippon Jinzo Gakkai Shi 1995;37:127–133.
Kiliś-Pstrusińska K, Wikiera-Magott I, Zwolińska D, Kopeć W, Rzeszutko M: Analysis of collagen IV and fibronectin in blood and urine in evaluation of nephrotic fibrosis in children with chronic glomerulonephritis. Med Sci Monit 2002;8:713–719.
Sakai Y, Inaba S, Matsukura H, Okada T: Serum IgA-fibronectin complex in children with various renal disease. Nippon Jinzo Gakkai Shi 1994;36:1130–1136.
Van Vliet A, Baelde HJ, Vleming LJ, de Heer E, Bruijn JA: Distribution of fibronectin isoforms in human renal disease. J Pathol 2001;193:256–262.
Yi M, Ruoslahti E: A fibronectin fragments inhibits tumor growth, angiogenesis, and metastasis. Proc Natl Acad Sci USA 2001;98:620–624.
Alekseevskikh IuG, Bobkova VP, Razdol’kina TI, Gozalishvili TV, Sergeeva TV: Fibronectin levels in blood, urine and kidney in children with kidney disease (in Russian). Arkh Patol 1993;55:33–36.
Bircmbaut P, Gaillard D, Labat-Robert J, Robert I: Distribution of fibronectin in renal pathology (in French). Nephrologie 1982;3:23–26.
Moranne O, Watier L, Rossert J, et al: Primary glomerulonephritis: an update on renal survival and determinants of progression. QJM 2008;101:215–224.
Ruggenenti P, Perticucci E, Cravedi P, et al: Role of remission clinics in the longitudinal treatment of CKD. J Am Soc Nephrol 2008;19:1213–1224.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.