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Kidney Week

Abstract: TH-PO1117

Endothelial Cell Injury Marker CD146 Evaluates Disease Severity and Predicts Renal Outcomes of Early Diabetic Nephropathy

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Fan, Ying, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
  • Fei, Yang, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
  • Wang, Yiyun, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
  • Wen, Jiejun, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
  • He, John Cijiang, Mount Sinai School of Medicine, New York, New York, United States
  • Wang, Niansong, Shanghai 6th People's Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
Background

Glomerular endothelial cell injury plays a crucial role in the development of diabetic nephropathy (DN). CD146, an endothelial marker, was shown to increase in chronic kidney disease (CKD), but its role in DN remains unknown.In the current study, we examined the circulating levels of sCD146 in plasma and renal expression of CD146 in kidney biopsies of DN patients at different CKD stages. We evaluated whether CD146 could be used to assess the severity of disease and predict renal outcomes in DN at early stages.

Methods

159 non-dialysis type 2-DN patients from 2008 to 2015 were enrolled to measure the plasma concentration of soluble CD146 (sCD146). 94 diabetes mellitus (DM) patients without DN and 100 healthy subjects were used as controls. The patients with CKD stage 1-3 were referred as early stages. Another independent cohort of 48 patients with biopsy-proved DN was used for the immunohistochemistry study of CD146. Renal outcomes were defined as doubling of serum creatinine, progression to end-stage renal disease or death.

Results

The plasma levels of sCD146 was upregulated in patients with DN compared to those without DN. Elevated plasma sCD146 was inversely associated with renal function and proved to be a more optimal marker than urine albumin creatinine ratio (UACR) to evaluate disease severity in these DN patients. Staining of kidney sections showed that CD146 was co-localized with endothelial marker CD31 and its expression increased in DN when compared with minimal change disease (MCD) and normal controls. The positive area of CD146 staining in kidney was correlated with the severity of pathological changes in these DN patients. Survival analysis suggested that both plasma levels of sCD146 and the biopsy expression of CD146 were correlated with the renal outcomes.

Conclusion

Plasma CD146 levels and its renal expression are associated with kidney injury and renal function and could be potentially developed as a marker to predict renal outcomes in patients with early stages of DN.

Funding

  • Government Support - Non-U.S.