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Abstract: TH-PO982

Urinary angiotensinogen predicts renal disease activity in lupus nephritis

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Author

  • Cao, Wei, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, GUANGDONG, China
Background

A non-invasive indicator of renal histological lesions and disease activity in lupus nephritis (LN) is needed for timely and targeted treatment before overt renal injury. Here, we tested the utility of urinary angiotensinogen (UAGT) to predict renal disease activity in LN.

Methods

A prospective, three-stage study was performed in patients with LN. In stage I, UAGT was measured in 140 newly-diagnosed LN patients. In stage II, UAGT was monitored in 61 subjects from stage I for up to 12 months. In stage III, UAGT was monitored in 12 LN patients before, during and after the onset of renal flares.

Results

In stage I, UAGT significantly increased in LN patients, correlating well with kidney AGT expression and histological activity. Patients with LN Class IV exhibited the highest UAGT compared with other histopathological classes of LN. For identifying LN class IV, a particularly aggressive type of LN, UAGT outperformed the conventional clinical measures and improved their performances. In stage II, UAGT decreased after immunotherapy and remained low in patients with LN remission during follow-up. In stage III, an elevation in UAGT predicted recurrence of LN, and a decline in UAGT after a renal flare heralded the remission of disease before conventional clinical measures.

Conclusion

UAGT in LN is a promising indicator for dynamical surveillance of renal disease activity and prediction of renal flares.

Funding

  • Government Support - Non-U.S.