Abstract: SA-PO105

Anti-CRP Antibodies in Patients with Lupus Nephritis: Extended Follow-Up

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Pesickova, Satu Sinikka, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czechia
  • Lenicek, Martin, First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czechia
  • Rysava, Romana, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czechia
  • Hruskova, Zdenka, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czechia
  • Tesar, Vladimir, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czechia
Background

Antibodies against monomeric CRP (anti-CRP-Ab) in patients with lupus nephritis (LN) seemed to be strong risk factor for poor outcome: non response to therapy, renal flare, end stage renal disease (ESRD) after two years of standard therapy, as it was shown in our previous study. The aim of this retrospective study is to verify the utility of anti-CRP- Ab in longer term follow-up.

Methods

Twenty three patients (1 male) with new diagnosis of LN proven by renal biopsy were followed-up for median (25-75%) of 8.9 (7.8-9.35) years. At the end of follow up (May 2017) renal and mortality data were collected. Unfavorable outcome was defined as ESRD, renal flare and non response to therapy.
Baseline anti-CRP-Ab levels were measured by an in-house ELISA and compared regarding to the outcome (Mann Whitney test). ROC curve was constructed to define anti-CRP- Ab threshold level. Predictive value of anti-CRP-Ab positivity was tested by Fisher exact test.

Results

During the long term follow-up 1 patient (without response to therapy) died (anti-CRP-Ab positive), 6 patients experienced at least one renal flare (4 were anti-CRP-Ab positive), 3 patients progressed to ESRD (2 were anti-CRP-Ab positive).
Baseline levels of anti-CRP-Ab were higher in patients with unfavorable outcome (53.9 vs 31.6 AU) p=0.023. Area under ROC curve was 0.81, sensitivity and specificity for given threshold (44 AU) was 81% and 70%, respectively.
Anti-CRP-Ab positive patients seemed to have higher risk of unfavorable outcome when compared to those anti-CRP-Ab negative: OR=6.00 (0.67-75.61), p=0.089.

Conclusion

Anti-CRP- Ab seem to be promising prognostic marker of theraputic outcome. Further studies on larger groups should be performed.