Biochemical markers of nephrotic syndrome: An observational, cross-sectional study

Emmanuel Kwaku Ofori; Egyam Bill Clinton; Obed Danso Acheampong; Henry Asare- Anane; Seth Kwabena Amponsah; Jayasinghe Su; Seth Dortey Amanquah

doi:10.1016/j.heliyon.2023.e15198

Biochemical markers of nephrotic syndrome: An observational, cross-sectional study

Heliyon. 2023 Apr 5;9(4):e15198. doi: 10.1016/j.heliyon.2023.e15198. eCollection 2023 Apr.

Authors

Emmanuel Kwaku Ofori¹, Egyam Bill Clinton^{1

2}, Obed Danso Acheampong^{1

3}, Henry Asare- Anane¹, Seth Kwabena Amponsah⁴, Jayasinghe Su⁵, Seth Dortey Amanquah¹

Affiliations

¹ Department of Chemical Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
² MDS-Lancet Laboratories Ghana Limited, Accra, Ghana.
³ School of Veterinary Medicine, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.
⁴ Department of Medical Pharmacology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
⁵ School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia.

Abstract

Background: Blood protein leakage, especially albumin, into the urine is the hallmark of nephrotic syndrome (NS), which poses a serious public health problem. The absence of albumin prompts the liver to produce more proteins to make up the difference. The therapeutic significance of these additional proteins in NS is not yet fully understood.

Methods: In total, 99 patients with NS and 47 persons without NS (control group) were included in this cross-sectional study. Socio-demographic and clinical information were obtained from recruits utilizing a standard questionnaire and a check of the lab order forms for individuals. Each participant had a 6-mL (6 mL) sample of venous blood taken and levels of calcium, C-reactive protein (CRP), albumin, and other proteins in the serum were assayed. The proteins in serum were separated using the electrophoresis technique, and the various fractions were then measured by a densitometer. Calculations were made for the oncotic pressure.

Results: The NS group had significantly greater levels of serum CRP, urea, alpha-2-globulin, gamma globulins, and M component than the control group (p < 0.05 respectively). Transferrin, total proteins, albumin, beta-1-globulins, calcium, and oncotic pressure were significantly higher in persons without NS compared to the NS group (p < 0.05 respectively). In addition, levels of CRP (odds ratio = 1.41, p = 0.005) and gamma globulin (odds ratio = 4.12, p = 0.005) in the blood were observed to be independent predictors in the occurrence of NS. These two factors increased the likelihood of developing NS by approximately 1.5 and 4 times, respectively.

Conclusion: Among the proteins assayed, CRP and gamma globulin were found to be predictors of NS. Nonetheless, further studies are required to understand the mechanisms associated with these serum proteins in NS.

Keywords: Albumin; Electrophoresis; Kidney; Nephrotic syndrome; Proteins.