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Abstract: FR-PO837

Urine Biomarkers for Kidney Injury in IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Zhang, Li, Ohio State University, Columbus, Ohio, United States
  • Zhang, Xiaolan, The Ohio State University, Columbus, Ohio, United States
  • Birmingham, Daniel J., Ohio State University, Columbus, Ohio, United States
  • Satoskar, Anjali A., Ohio State University, Columbus, Ohio, United States
  • Rovin, Brad H., Ohio State University Wexner Medical Center, Columbus, Ohio, United States
Background

IgA nephropathy is the most common primary glomerular disease leading to chronic kidney disease. Clinical management and prognosis rely heavily on renal pathology; reliable biomarkers are needed for non-invasive evaluation of the kidney. The aim of this study was to investigate potential urine biomarkers of kidney injury severity in IgAN.

Methods

Spot urines were collected from 45 IgAN patients at the time of diagnostic kidney biopsy and 29 healthy volunteers (control). Biopsies were classified by the Oxford system and the degree of activity and chronic damage was recorded blindly as none, mild, moderate or severe by the renal pathologist. The candidate biomarkers of kidney injury we assessed were adiponectin, CD163, EGF, NGAL, ICAM1, VCAM1 and complement component C5a. These were measured in urine using R&D DuoSet ELISAs. ANOVA, nonparametric Wilcoxon test and multiple linear regression were done using JMP14 pro for data analysis.

Results

Urine adiponectin, CD163, C5a and VCAM-1 were significantly different than healthy controls with fold-increases of 7, 399, 28 and 7 respectively (all p<0.0001), while EGF decreased about 1.4-fold compared to control (p=0.0015). Urine EGF was inversely correlated with interstitial fibrosis and tubular atrophy (IFTA, R2=0.35, p < 0.0001) and overall chronicity (R2=0.49, p<0.0001), while C5a positively correlated with IFTA (R2=0.21, p=0.0018). Adiponectin and C5a were both positively correlated with overall activity (based on biopsy MEST score) (R2=0.51, p=0.0008 and R2= 0.38, p=0.008, respectively). Using receiver operating characteristic analysis, the area under the curve for EGF to differentiate between mild and moderate-severe chronic injury is 0.91 (p<0.0001), and for adiponectin to detect the presence of active lesions is 0.96 (p=0.0011).

Conclusion

Urine EGF could serve as a biomarker for chronic kidney lesions in IgAN while adiponectin and complement 5a may be biomarkers for active kidney lesions. These biomarkers could be helpful in non-invasively evaluating the efficacy of therapies for IgAN.

Funding

  • Clinical Revenue Support