ArticlePloS one2014
A non-invasive laboratory panel as a diagnostic and prognostic biomarker for thrombotic microangiopathy: development and application in a Chinese cohort study.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 22 citations in OpenAlex.
- Comparison of biomarkers and laboratory results in unaffected, moderate, and severe COVID-19 recovered patients.Future science OA · 2025Article
- Treatment of thrombotic microangiopathy associated with systemic lupus erythematosus with low-dose rituximab as an induction agent and belimumab as a maintenance agent.BMC pediatrics · 2025Article
- LDH and NLR, as inflammatory markers, the independent risk factors for COVID-19 complicated with respiratory failure in elderly patients.Pakistan journal of medical sciences · 2024Article
- Relationship between serum lactate dehydrogenase levels and prognosis in patients infected with omicron and delta variants of COVID-19: A cross-sectional study.Toxicology reports · 2023Article
- The Effects of Exercise Training on Recovery of Biochemical and Hematological Outcomes in Patients Surviving COVID-19: A Randomized Controlled Assessor-Blinded Trial.Sports medicine - open · 2022Article
- Article
- Assessment of some Physiological Biomarkers in COVID-19 Patients in Thi-Qar, Iraq.Archives of Razi Institute · 2022Article
- Clinical Characteristics and Predictors of Mortality in Minority Patients Hospitalized with COVID-19 Infection.Journal of racial and ethnic health disparities · 2022Article
- Predicting Severe Disease and Critical Illness on Initial Diagnosis of COVID-19: Simple Triage Tools.Frontiers in medicine · 2022Article
- Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis.The American journal of emergency medicine · 2020Review
- Profiles of Coagulation and Fibrinolysis Activation-Associated Molecular Markers of Atypical Hemolytic Uremic Syndrome in the Acute Phase.Journal of atherosclerosis and thrombosis · 2020Article
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8 authors at 2 institutions in 1 country.
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Abstract
backgroundThrombotic microangiopathy (TMA) in the kidney is a histopathologic lesion that occurs in a number of clinical settings and is often associated with poor renal prognosis. The standard test for the diagnosis of TMA is the renal biopsy; noninvasive parameters such as potential biomarkers have not been developed.
methodsWe analyzed routine parameters in a cohort of 220 patients with suspected TMA and developed a diagnostic laboratory panel by logistic regression. The levels of candidate markers were validated using an independent cohort (n = 46), a cohort of systemic lupus erythematosus (SLE) (n = 157) and an expanded cohort (n = 113), as well as 9 patients with repeat biopsies.
resultsOf the 220 patients in the derivation cohort, 51 patients with biopsy-proven TMA presented with a worse renal prognosis than those with no TMA (P = 0.002). Platelet and L-lactate dehydrogenase (LDH) levels showed an acceptable diagnostic value of TMA (AUC = 0.739 and 0.756, respectively). A panel of 4 variables - creatinine, platelets, ADAMTS13 (a disintegrin and metalloprotease with thrombospondin type 1 repeats 13) activity and LDH - can effectively discriminate patients with TMA (AUC = 0.800). In the validation cohort, the platelet and LDH levels and the 4-variable panel signature robustly distinguished patients with TMA. The discrimination effects of these three markers were confirmed in patients with SLE. Moreover, LDH levels and the 4-variable panel signature also showed discrimination values in an expanded set. Among patients undergoing repeat biopsy, increased LDH levels and panel signatures were associated with TMA status when paired evaluations were performed. Importantly, only the 4-variable panel was an independent prognostic marker for renal outcome (hazard ratio = 3.549; P<0.001).
conclusionsThe noninvasive laboratory diagnostic panel is better for the early detection and prognosis of TMA compared with a single parameter, and may provide a promising biomarker for clinical application.
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