Kidney Week

Abstract: SA-PO508

Urinary Epidermal Growth Factor/Monocyte Chemotactic Peptide 1 Ratio Predicts Outcome in Patients with Autosomal Dominant Polycystic Kidney Disease

Session Information

• ADPKD: Clinical Studies
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Genetic Diseases of the Kidney

• 1001 Genetic Diseases of the Kidney: Cystic

Authors

• Matino, Silvia, University of Bari, Porto Cesareo, Italy

Silvia Matino,

• Rocchetti, Maria Teresa, University of Foggia-Faculty of Medicine-Biomedical Sciences Department, Fogga, Italy

Maria Teresa Rocchetti,

• Pesce, Francesco, University of Bari, Porto Cesareo, Italy

Francesco Pesce,

• Piscopo, Giovanni, Ospedale della Murgia, Altamura, Italy

Giovanni Piscopo,

• Gigante, Maddalena, University of Foggia , Foggia, Italy

Maddalena Gigante,

• Trepiccione, Francesco, University of Campania "Luigi Vanvitelli", Napoli, Italy

Francesco Trepiccione,

• Capolongo, Giovanna, Second University of Naples, Naples, Italy

Giovanna Capolongo,

• Moschetta, Marco A., University of Bari Medical School, BARI, Italy

Marco A. Moschetta,

• Capasso, Giovambattista, University of Campania Luigi Vanvitelli, Napoli, Italy

Giovambattista Capasso,

• Gesualdo, Loreto, University of Bari, Porto Cesareo, Italy

Loreto Gesualdo,

Background

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited condition leading to end stage renal disease, but it is difficult to predict the rate of disease progression. Total kidney volume (TKV) is an independent prognostic marker of renal function decline and is used to define the Mayo classification. Urinary Epidermal Growth Factor/Monocyte Chemotactic Peptide 1 ratio (uEGF/MCP1) has been shown to be a prognostic biomarker in IgA nephropathy. In this study, we tested the role of uEGF/MCP1 in predicting outcome of ADPKD patients according to the Mayo classification.

Methods

A cohort of 46 (32 F, 14 M) patients with ADPKD consecutively enrolled was evaluated. Urinary EGF and MCP1 levels were measured by ELISA. TKV calculation and Mayo classification were based on MRI measurements. The Mayo classification was used for the prediction of the eGFR at 10 years to calculate the ΔT0-T10. The outcome was defined as follows: Mayo Classes 1A-1B patients were classified as “non-progressors”, whereas 1C-1E patients were classified as rapid disease “progressors” (corresponding to a predicted eGFR decrease ≥2.5 mL/min/1.73 m2 per year).

Results

Clinical data at baseline (T0) were the following: age 44±13 years, eGFR 71±32 ml/min/1.73 m², TKV 1239 (731–2287) ml, uEGF/MCP1 58.5 (16.8–127.1), Mayo Class (no.) 1A (3), 1B (10), 1C (13), 1D (16), 1E (4), progressors/non-progressors (no.) 33/13. uEGF/MCP1 at T0 was significantly different across Mayo Classes (p=2.14e-05) showing a trend towards a reduction in Class 1E and correlated with the predicted variation of eGFR at 10 years (ΔT0-T10, r =-0.405, p=0.004). In addition, both urinary EGF (r=-0.313, p=0.027) and MCP1 (r=0.404, p=0.004) correlated with the ΔT0-T10.
In a multivariate analysis including adjustment for age and sex we found that uEGF/MCP1 at T0 is an independent predictor of outcome (OR 0.98; 95% CI: 0.97-0.99, p=0.005) and this model showed an area under the ROC curve of 0.90 (95% CI: 0.81-0.98), achieving a specificity of 0.92 and a sensitivity of 0.82.

Conclusion

These findings show that uEGF/MCP1 can be used as a reliable and non-invasive biomarker for the estimation of disease progression in patients with ADPKD.

Funding

• Government Support - Non-U.S.