O. Hotta et al., DETECTION OF MATURE MACROPHAGES IN URINARY SEDIMENTS - CLINICAL-SIGNIFICANCE IN PREDICTING PROGRESSIVE RENAL-DISEASE, Renal failure, 20(2), 1998, pp. 413-418
The ability to predict the rate of progression of renal parenchymal di
sease may help in its clinical management. We undertook characterizati
on of urinary macrophages obtained from patients with various renal di
seases paying special attention to the differentiation from nonprogres
sive to progressive renal diseases. A total of 84 patients were divide
d into one of three categories. A highly progressive group included pa
tients with rapidly progressive glomerulonephritis, diabetic nephropat
hy, membranoproliferative glomerulonephropathy, primary focal segmenta
l sclerosis and diffuse proliferative lupus nephropathy, moderately pr
ogressive group included those with IgA nephropathy and Alport's syndr
ome and non-progressive group included patients with thin basement mem
brane nephropathy, minimal change nephrotic syndrome, idiopathic renal
hematuria and urolithiasis. Urinary sediments were reacted with four
monoclonal antibodies (CD68/macrophages vimentin, cytokeratin, and 25F
9/mature macrophages). In normal individuals mature macrophages (25F9(
+) cells) were absent in urinary sediments. The number of 25F9(+) cell
s in the urine was highest in the highly progressive group, less promi
nent in the moderately progressive group, and virtually absent in the
non-progressive group. The 25F9(+) cells reacted with anti-CD68 and an
tivimentin antibody, whereas the 25F9(+) cells did not react with anti
-cytokeratin antibody. These findings indicate that the defection of m
ature macrophages in urine is useful to estimate the prognosis of rena
l parenchymal diseases and may help to differentiate some glomerular d
iseases (e.g. thin basement membrane disease vs. Alport's syndrome, an
d minimal change nephrotic syndrome vs. primacy focal segmental sclero
sis).