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Abstract: TH-PO831

Urine IP-10 Increased Sensitivity in Lupus Nephritis Detection

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Kittanamongkolchai, Wonngarm, Chulalongkorn University, Bangkok, Thailand
  • Chewcharat, Api, Chulalongkorn University, Bangkok, Thailand
  • Avihingsanon, Yingyos, Chulalongkorn University, Bangkok, Thailand

Group or Team Name

  • Renal Immunology and Therapeutic Apheresis Research Unit
Background

Interferon γ-inducible protein(IP-10) is an important T-helper1 chemokine expressed locally in the kidney of lupus patients. Non-invasive test for urine IP-10 may improve the detection of active lupus nephritis(LN).

Methods

Since 2013, urine IP-10 has been measured in all SLE patients with clinical suspicion of LN at the specialized LN clinic in a tertiary care hospital in Thailand. We retrospectively reviewed the case records of those who underwent renal biopsy from October 2013 to February 2018 and had urine IP-10 measurement within 90 days from date of renal biopsy.

Results

Of 176 SLE patients followed at LN clinic, 47 had renal biopsy with urine IP-10 measurement within the certain period. Urine IP-10 was positive (> 2 log copies number) in 42 out of 45 patients(93%) with biopsy-proven proliferative LN, while proteinuria was found (UPCI > 1) in 41 patients (91%). Two patients who had only renal scarring on biopsy had proteinuria, while urine IP-10 was negative in 1 patient(Figure 1).

Four patients with proliferative LN who had positive urine IP-10 without proteinuria were noted for focal podocyte foot process effacement (Table 1). All of them had stable renal function and normalization of C3 without proteinuric flare after 6-month of induction therapy.

There were 8 patients who had serial urine IP-10 measurement prior to renal biopsy. In 6 patients, urine IP-10 was positive before proteinuric flare (median 6 months), whereas 2 patients were simultaneously positive for proteinuria and IP-10.

Conclusion

Urine IP-10 enhances sensitivity of LN detection, especially in those without proteinuria. Its levels even increased prior to proteinuric flare in most cases. Combined use of urine IP-10 and conventional markers may increase early detection of LN and ultimately improve renal outcomes

Funding

  • Government Support - Non-U.S.