Urinary Nephrin: A Potential Biomarker of Early Glomerular Injury in a Cohort of Pregnant Women
1
College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia, Universty of Gondar, Ethiopia, Gondar, Ethiopia, Ethiopia
2
1College of Public Health, Medical and Veterinary Science, James Cook University, 1 James Cook Drive, Douglas, Townsville, Queensland 4811, Australia, James Cook University, Cranbrook/Townsville, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Glomerular injury can occur during pregnancy due to systemic diseases or pregnancy-related complications. Although urinary nephrin helps identify preeclampsia (PE) early in high-risk pregnancies, its role in detecting glomerular injury in pregnant women remains unclear. This study aimed to assess urinary nephrin as a potential predictor of early glomerular injury. Methods and Materials: A cross-sectional study was conducted. All pregnant women with a full dataset (n = 273) were classified into three categories according to their urinary albumin-to-creatinine ratio (ACR): normoalbuminuria, microalbuminuria, and macroalbuminuria. Continuous variables were compared between groups, and the cut-off value for the urinary nephrin-to-creatinine ratio (NCR) was determined to predict albuminuria as an indirect indicator of early glomerular injury. The percentages of pregnant women who had elevated nephrinuria were calculated for each of the ACR categories.
RESULTS:
Urinary NCR correlated positively with ACR (r = 0.29, p < 0.0001) and increased across normo-, micro-, and macroalbuminuria groups. Using a 14 ng/mg cutoff, nephrinuria was found in 65% of normoalbuminuric, 95% of microalbuminuric, and 100% of macroalbuminuric women. Among normoalbuminuric women with elevated NCR (>14 ng/mg), 78% had hypertensive disorders and 63% had diabetes in pregnancy. Women with PE showed significantly higher NCR and ACR levels than those without PE. The area under the curve for NCR was 0.74 (95% CI: 0.65–0.82), with 97% sensitivity and 36% specificity for glomerular injury, and 93% sensitivity and 42% specificity to predict glomerular injury of PE.
CONCLUSIONS:
The study found elevated urinary NCR in women with micro-, macro-, and even normoalbuminuria. Increased NCR without elevated albumin may indicate early glomerular injury. Thus, urinary NCR could be a more sensitive marker than microalbuminuria for detecting early glomerular injury in women with systemic disease or adverse pregnancy outcomes.
Glomerular injury can occur during pregnancy due to systemic diseases or pregnancy-related complications. Although urinary nephrin helps identify preeclampsia (PE) early in high-risk pregnancies, its role in detecting glomerular injury in pregnant women remains unclear. This study aimed to assess urinary nephrin as a potential predictor of early glomerular injury. Methods and Materials: A cross-sectional study was conducted. All pregnant women with a full dataset (n = 273) were classified into three categories according to their urinary albumin-to-creatinine ratio (ACR): normoalbuminuria, microalbuminuria, and macroalbuminuria. Continuous variables were compared between groups, and the cut-off value for the urinary nephrin-to-creatinine ratio (NCR) was determined to predict albuminuria as an indirect indicator of early glomerular injury. The percentages of pregnant women who had elevated nephrinuria were calculated for each of the ACR categories.
RESULTS:
Urinary NCR correlated positively with ACR (r = 0.29, p < 0.0001) and increased across normo-, micro-, and macroalbuminuria groups. Using a 14 ng/mg cutoff, nephrinuria was found in 65% of normoalbuminuric, 95% of microalbuminuric, and 100% of macroalbuminuric women. Among normoalbuminuric women with elevated NCR (>14 ng/mg), 78% had hypertensive disorders and 63% had diabetes in pregnancy. Women with PE showed significantly higher NCR and ACR levels than those without PE. The area under the curve for NCR was 0.74 (95% CI: 0.65–0.82), with 97% sensitivity and 36% specificity for glomerular injury, and 93% sensitivity and 42% specificity to predict glomerular injury of PE.
CONCLUSIONS:
The study found elevated urinary NCR in women with micro-, macro-, and even normoalbuminuria. Increased NCR without elevated albumin may indicate early glomerular injury. Thus, urinary NCR could be a more sensitive marker than microalbuminuria for detecting early glomerular injury in women with systemic disease or adverse pregnancy outcomes.
| eISSN: | 2654-1459 |
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