{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:26:17Z","timestamp":1762867577666,"version":"build-2065373602"},"reference-count":16,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T00:00:00Z","timestamp":1538611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We report a case of a pregnant woman with nephrotic syndrome due to biopsy-proven focal segmental glomerulosclerosis (FSGS) whose fetus developed echogenic kidneys and severe oligohydramnios by 27 weeks of gestation. Maternal treatment with prednisone resulted in normalization of the amniotic fluid indices and resolution of fetal renal echogenicity. The newborn was noted to have transient renal dysfunction and proteinuria, resolving by 6 weeks postpartum. The transplacental passage of permeability factors is postulated to have caused both the fetal and newborn renal presentation, with significantly elevated levels of soluble urokinase-type plasminogen activator receptor (suPAR) noted in the cord blood. This case documents the transplacental maternal-fetal transmission of suPAR, demonstrating the potential for maternal-fetal transmission of deleterious, disease-causing entities, and adds to the differential diagnosis of fetal echogenic kidneys. Further, this is the first documentation of a fetal response to maternal systemic therapy.<\/jats:p>","DOI":"10.3390\/jcm7100324","type":"journal-article","created":{"date-parts":[[2018,10,4]],"date-time":"2018-10-04T12:29:57Z","timestamp":1538656197000},"page":"324","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fetal Renal Echogenicity Associated with Maternal Focal Segmental Glomerulosclerosis: The Effect of Transplacental Transmission of Permeability Factor suPAR"],"prefix":"10.3390","volume":"7","author":[{"given":"Shirley","family":"Shuster","sequence":"first","affiliation":[{"name":"The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON M5G 1Z5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghada","family":"Ankawi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Sunnybrook Science Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Licht","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada"},{"name":"Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Reiser","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4091-8196","authenticated-orcid":false,"given":"Xuexiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changli","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Chitayat","sequence":"additional","affiliation":[{"name":"The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON M5G 1Z5, Canada"},{"name":"Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Hladunewich","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Sunnybrook Science Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/MNH.0000000000000408","article-title":"Advances in molecular diagnosis and therapeutics in nephrotic syndrome and focal and segmental glomerulosclerosis","volume":"27","author":"Sharif","year":"2018","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1108","DOI":"10.1016\/j.transproceed.2008.03.076","article-title":"Renal transplantation in primary focal segmental glomerulosclerosis using a tolerance induction protocol","volume":"40","author":"Suthar","year":"2008","journal-title":"Transplant. Proc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2907","DOI":"10.1111\/j.1600-6143.2005.01112.x","article-title":"Preemptive plasmapheresis and recurrence of FSGS in high-risk renal transplant recipients","volume":"5","author":"Gohh","year":"2005","journal-title":"Am. J. Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1177\/153537020422900111","article-title":"The focal segmental glomerulosclerosis permeability factor: Biochemical characteristics and biological effects","volume":"229","author":"Sharma","year":"2004","journal-title":"Exp. Biol. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/nm1696","article-title":"Modification of kidney barrier function by the urokinase receptor","volume":"14","author":"Wei","year":"2008","journal-title":"Nat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1038\/nm.2411","article-title":"Circulating urokinase receptor as a cause of focal segmental glomerulosclerosis","volume":"17","author":"Wei","year":"2011","journal-title":"Nat. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1038\/nm.4362","article-title":"A tripartite complex of suPAR, APOL1 risk variants and alphavbeta3 integrin on podocytes mediates chronic kidney disease","volume":"23","author":"Hayek","year":"2017","journal-title":"Nat. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1056\/NEJMoa1506362","article-title":"Soluble urokinase receptor and chronic kidney disease","volume":"373","author":"Hayek","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1056\/NEJM200102013440517","article-title":"Transmission of glomerular permeability factor from a mother to her child","volume":"344","author":"Kemper","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1053\/j.ajkd.2012.10.011","article-title":"Transmission of glomerular permeability factor soluble urokinase plasminogen activator receptor (suPAR) from a mother to child","volume":"61","author":"Kemper","year":"2013","journal-title":"Am. J. Kidney Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/MJT.0b013e3182811aca","article-title":"Management of severe recurrent focal segmental glomerulosclerosis through circulating soluble urokinase receptor modification","volume":"20","author":"Morath","year":"2013","journal-title":"Am. J. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4632768","DOI":"10.1155\/2016\/4632768","article-title":"FSGS: Diagnosis and diagnostic work-up","volume":"2016","author":"Sprangers","year":"2016","journal-title":"BioMed Res. Int."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Francis, A., Didsbury, M., McCarthy, H., and Kara, T. (2018). Treatment of recurrent focal segmental glomerulosclerosis post-kidney transplantation in Australian and New Zealand children: A retrospective cohort study. Pediatr. Transplant., 22.","DOI":"10.1111\/petr.13185"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMoa012895","article-title":"Antenatal membranous glomerulonephritis due to anti-neutral endopeptidase antibodies","volume":"346","author":"Debiec","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.2214\/AJR.11.8083","article-title":"Imaging and classification of congenital cystic renal diseases","volume":"198","author":"Avni","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1002\/pd.1185","article-title":"Fetal hyperechogenic kidney with normal amniotic fluid volume: A diagnostic dilemma","volume":"25","author":"Mashiach","year":"2005","journal-title":"Prenat. Diagn."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/7\/10\/324\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:23:58Z","timestamp":1760196238000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/7\/10\/324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,4]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,10]]}},"alternative-id":["jcm7100324"],"URL":"https:\/\/doi.org\/10.3390\/jcm7100324","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2018,10,4]]}}}