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Abstract: SA-PO389

First-in-Man Cross-Sectional Single Center Study of Multimarker Panel Validation for Early Prediction of Morphological Lesions in Patients with Primary Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Saganova, Elena, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Galkina, Olga, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Sipovskii, Vasiliy, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
  • Smirnov, Alexey, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg, Russian Federation
Background

Measurement of various biomarkers (BM) as a predictors of morphological lesions can improve detection and risk stratification for CKD progression. Our aim was to evaluate combination of serum und urinary BM as a predictor of various morphological lesions in patients with glomerulonephritis (GN)

Methods

100 patients[52 male; age Me(min 18;max 83) – 39(27; 54) years] with biopsy proven GN, without AKI, infectious diseases, severe heart failure, respiratory insufficiency, cancer, abnormal thyroid status, prednisolone treatment more than 10 mg/per day were included in the study. Based on the results of kidney biopsy in 9% of cases minimal change disease was diagnosed, in 28% – focal segmental glomerulosclerosis, in 26% – membranous nephropathy and in 37% – IgA-nephropathy.Serum/urine (24-hour collection) creatinine (sCr/uCr), cystatin C (sCysC/uCysC), EFMg, urinary transferrin (uTr), IgG (uIgG), α1-microglobulin, β2-microglobulin were measured in the morning on the day of biopsy. The extent of glomerulosclerosis (GS) was assessed quantitatively, tubulo-interstitial fibrosis(TIF), tubular atrophy(TA) - semi-quantitatively. According to the degree of each morphological lesions (GS/TIF/TA) all patients consistently were separated into 2 groups: “light”(GS less than 25% or TIF/TA grade 0 or 1) and “severe”(GS ≥ than 25% or TIF/TA grade 2-3). We evaluated specificity, sensitivity diagnostic accuracy of BM panel regarding to the extent of GS/TIF/TA by multivariate and ROC-analysis

Results

Discriminant linear function analysis followed by ROC analysis showed that from included to the panel BM (Figure 1): GS (Biomarker Panel 1 (BP1); p<0.001; Fig1A), TIF (BP2; p<0.001; Fig1B), TA (BP3; p<0.001; Fig1C) were associated with sCr, sCysC, uTr, uIgG

Conclusion

Combination of sCr, sCysC, uTr, uIgG is a significant biomarker panel of various morphological lesions in patient with GN and can be used as a strong predictor of mild degree of GS, TIF and TA with high sensitivity, specificity and accuracy.

Figure 1. ROC curves with 95% CI of Biomarkers Panels for A – GS; B – TIF; C – TA

Funding

  • Government Support - Non-U.S.