■肾损伤分子-1(KIM-1)和骨膜素(POSTN)是近端和远端小管损伤生物标志物。我们测试了基线尿液KIM-1/肌酐（uKIM-1/cr）和/或uPOSTN/cr是否与疾病严重程度相关或改善了缓解预测模型。
■基线uKIM1/cr和uPOSTN/cr是在2014年12月15日之前纳入肾病综合征研究网络的无免疫抑制患者的点尿样上测量的。在基线测量尿蛋白/肌酐（UPCR）和白蛋白/肌酐（UACR），4个月,直到最后一次随访。从临床指示的活检期间收集的基线研究肾活检核心分析肾小球和肾小管间质(TI)表达阵列。肾脏诊断得到了集中证实，扫描的部分,并进行形态测量。基线uKIM-1/cr和uPOSTN/cr与UPCR的相关性，UACR,组织病理学特征,肾小球和TIKIM-1和POSTN表达水平，并评估肾脏结局.
■基线uKIM-1/cr与UPCR和UACR相关，与调整蛋白尿后完全缓解有关，组织病理学诊断,和治疗。基线uKIM-1/cr也与足突消退和急性肾小管损伤的程度相关。肾小球和TIKIM-1表达水平与UPCR和UACR相关。较高的TIKIM-1表达水平与间质纤维化相关，肾小管萎缩,和全球肾小球硬化，而肾小球KIM-1表达与缓解时间相关。POSTN的结果具有较小的统计强度。
■较低的基线uKIM-1/cr值与调整蛋白尿后更快的完全缓解时间相关，组织病理学诊断,和治疗。在蛋白尿状态中TIKIM-1表达水平的增加与慢性形态学损伤相关;较低的肾小球表达水平与更大的蛋白尿可逆性相关。
UNASSIGNED: Kidney injury molecule-1 (KIM-1) and periostin (POSTN) are proximal and distal tubule injury biomarkers. We tested whether baseline urine KIM-1/creatinine (uKIM-1/cr) and/or uPOSTN/cr correlated with disease severity or improved a remission prediction model.
UNASSIGNED: Baseline uKIM1/cr and uPOSTN/cr were measured on spot urine samples from immunosuppression-free patients enrolled in Nephrotic Syndrome Study Network until December 15, 2014. Urine protein/creatinine (UPCR) and albumin/creatinine (UACR) were measured at baseline, 4 months, and until last follow-up. Glomerular and tubulointerstitial (TI) expression arrays were analyzed from a baseline research renal biopsy core collected during a clinically indicated biopsy.Renal diagnoses were centrally confirmed, sections scanned, and measured morphometrically. Correlations between baseline uKIM-1/cr and uPOSTN/cr and UPCR, UACR, histopathologic features, glomerular and TI KIM-1 and POSTN expression levels, and renal outcomes were assessed.
UNASSIGNED: Baseline uKIM-1/cr correlated with UPCR and UACR, and were associated with complete remission after adjustment for proteinuria, histopathologic diagnosis, and treatment. Baseline uKIM-1/cr also correlated with degree of foot process effacement and acute tubular injury. Glomerular and TI KIM-1 expression levels correlated with UPCR and UACR. Higher TI KIM-1 expression levels correlated with interstitial fibrosis, tubular atrophy, and global glomerulosclerosis, while glomerular KIM-1 expression correlated with time to remission. Findings for POSTN were of lesser statistical strength.
UNASSIGNED: Lower baseline uKIM-1/cr values were associated with more rapid time to complete remission after adjusting for proteinuria, histopathologic diagnosis, and treatment. Increased TI KIM-1 expression levels in proteinuric states were associated with chronic morphological injury; lower glomerular expression levels were associated with a greater potential for proteinuria reversibility.
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