Kidney Week

Abstract: SA-PO612

Urinary Levels of CD11b and CD163 Determine Rapid Responders to Remission Induction Therapy in Proliferative Lupus Nephritis

Session Information

• Glomerular Diseases: Immunology, Inflammation - II
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1202 Glomerular Diseases: Immunology and Inflammation

Authors

• Karasawa, Munetoshi, Nagoya University Graduate School of Medicine, Nagoya, Japan

Munetoshi Karasawa,

• Hachiya, Asaka, Nagoya University, Nagoya, Japan

Asaka Hachiya,

• Tsuboi, Naotake, Fujita Health University School of Medicine, Toyoake, Japan

Naotake Tsuboi,

• Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan

Shoichi Maruyama,

• Furuhashi, Kazuhiro, Nagoya University, Nagoya, Japan

Kazuhiro Furuhashi,

Background

Drastic elevations of urinary CD11b (U-CD11b), α_m subunit of integrin Mac-1, and CD163 (U-CD163), a scavenger receptor for hemoglobin-haptoglobin complex, have been demonstrated in proliferative lupus nephritis (LN). The current study aims the further verifications of U-CD11b and U-CD163 as the potential LN biomarkers to predict longitudinal response of proliferative LN patients to the remission induction therapy.

Methods

We examined CD11b and CD163 by enzyme-linked immunosorbent assay in urine samples collected from proliferative LN class III or IV patients confirmed by renal biopsy in Nagoya Kidney Disease Registry (N-KDR) cohort between 2004 and 2014, and retrospectively analyzed those associations with longitudinal achievement of complete remission (CR) following the remission induction therapy. Based on the cut-off values of U-CD11b and U-CD163 respectively determined by receiver operation curves to predict CR, univariate analysis by log-rank test and multivariate analysis by cox proportional hazards regression model were performed to evaluate patient susceptibility to the remission induction therapy.

Results

Among 63 patients with proliferative LN for 52 months observation period on average, U-CD11b and U-CD163 levels were significantly higher in patients who achieved CR within 3 months (p<0.001 in U-CD11b, p=0.003 in U-CD163) and 12 months (p=0.02 in U-CD11b, p=0.03 in U-CD163) compared with those who did not. In univariate analysis, the cumulative CR rates within 3 months in patients presenting low levels of U-CD11b and U-CD163 were significantly higher than their respective high levels. Multivariate analysis revealed low level of U-CD11b (hazard ratio [HR], 5.68; 95% confidence interval [95% CI], 1.65 to 19.4) and eGFR per 10ml/min/1.73m² (HR, 1.30; 95% CI, 1.11 to 1.52) as independent predictors for the achievement of CR within 3 months. Moreover, low level of U-CD11b (HR, 4.69; 95% CI, 1.35 to 16.2) still demonstrated the significance even in the subpopulation with preserved renal function.

Conclusion

U-CD11b, rather than U-CD163, serve the clinical values for the prediction of early response to the remission induction therapy in LN patients.