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Abstract: TH-PO1009

Urinary Cytokines as Non-Invasive Biomarkers of IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kang, Min hye, Kyunghee University Hospital, Seoul, Korea (the Republic of)
  • Kim, Jin sug, Kyunghee University Hospital, Seoul, Korea (the Republic of)
  • Hwang, Hyeon Seok, Kyunghee University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yang gyun, Kyung Hee University Hospital at Gang-Dong, Seoul, Korea (the Republic of)
  • Jung, Su Woong, Kyung Hee University Hospital at Gang-Dong, Seoul, Korea (the Republic of)
  • Cho, Won-Hee, Kyung Hee University Hospital at Gang-Dong, Seoul, Korea (the Republic of)
  • Jeong, Kyung hwan, Kyunghee University Hospital, Seoul, Korea (the Republic of)
Background

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Although renal biopsy is the gold standard of diagnosis, accessibility in clinical practice is poor. Therefore, need for development of non-invasive diagnostic tools such as biomarker has emerged. In this study, we investigated the clinical relevance of 16 urinary cytokines in patients with IgAN.

Methods

The levels of 16 urinary cytokines from 110 biopsy-proven IgAN patients, 15 non-IgAN glomerulonephritis, and 15 normal controls were measured using multiplex assays. Samples were collected from the first spot urine of the morning on the day of renal biopsy. To account for variations in urine concentration, urinary cytokine levels were normalized to urine creatinine. We analyzed the correlations of urinary cytokines with clinical and pathological parameters in IgAN patients. The predictive value of urinary cytokines for adverse renal outcome, which defined as chronic kidney disease (CKD) stage 3 or above at the last follow-up, was also investigated using receiver operating characteristic (ROC) curve analysis

Results

As compared with patients in non-IgAN glomerulonephritis group and normal controls group, patients in the IgAN group showed significant higher urinary cytokine levels of interferon-inducible protein 10 (CXCL10), endocan, growth differentiation factor 15 (GDF15), interferon gamma (IFN-r), interleukin 6 (IL-6), mannan-binding lectin (MBL), nephrin, and transferrin R (TfR) (p < 0.05). The urinary levels of endocan, GDF-15, IL-6, and TfR showed significant correlation with estimated glomerular filtration rate (eGFR) (r=-0.240, p=0.005; r=-0.240, p=0.006; r=-0.254, p=0.003; and r=-0.386, p=0.001, respectively). Urinary protein excretion was significantly correlated with CXCL10, IL-6, and TfR (r=0.205, p=0.002; r=0.210, p=0.017; r=0.165, p=0.040, respectively). ROC curve analyses showed that urinary protein to creatinine ratio, GDF-15, and IL-6 had a moderately predictive value for adverse renal outcome (area under the curve > 0.7).

Conclusion

Urinary cytokines have potential as disease specific biomarkers of IgAN. Further large and prospective studies of extended duration are needed.