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Abstract: TH-PO988

The Levels of Plasma suPAR May Not Discriminate the Patients with Poor Therapeutic Reactivity Among Adult Japanese Focal Segmental Glomerulosclerosis and Minimal Change Disease

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Ozeki, Takaya, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Ishimoto, Takuji, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Kato, Sawako, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Yasuda, Yoshinari, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Maruyama, Shoichi, Nagoya University Graduate School of Medicine, Nagoya, Japan
Background

Soluble urokinase-type plasminogen activator receptor (suPAR) was originally reported as a specific biomarker for focal segmental glomerulosclerosis (FSGS). Recently, several studies negatively showed the importance of suPAR on the diagnosis of FSGS. However, there are few reports investigating the utility of suPAR as a marker for predicting therapeutic reactivity among adult minimal change disease (MCD) and FSGS.

Methods

Multicenter retrospective cohort study. Among the biopsy-proven MCD/FSGS patients during 2005-2015 at Nagoya university and 14 affiliated hospitals, the patients who collected their plasma at biopsy according their consent were included. Age>20, relapsed cases, non-nephrotic cases or cases who had already received any immunosuppressive treatment at biopsy were excluded. Plasma suPAR level were measured by ELISA (R&D Systems). The patients were divided into 2 groups whether they could attain complete remission within 4 weeks or not (responders or non-responders). We compared suPAR level between MCD/FSGS or responders/non-responders and evaluated the correlation suPAR level and other clinical variables.

Results

Ninety-nine cases (MCD/FSGS: 65/34, responders/non-responders: 67/32) were included to the analyses. The patients with FSGS or non-responders demonstrated more impaired kidney function at baseline. The median value of plasma suPAR was MCD/FSGS: 2253.8 vs. 3290.9 pg/mL(p<0.001) and responder/non-responder: 2334.1 vs. 3080.7 pg/mL(P=0.020). There was moderate negative correlation between plasma suPAR levels and eGFR (Speaman’s rho: -0.42). When analyzing the patients with eGFR>=60, the median value of plasma suPAR was MCD/FSGS: 2253.8 vs. 3290.9 pg/mL(p<0.001) and responder/non-responder: 2334.1 vs. 3080.7 pg/mL (P=0.55).

Conclusion

Plasma suPAR level was observed significantly higher among FSGS and non-responders. However, we cannot ignore the affection from the patients' kidney function. Among patients with preserved renal function, plasma suPAR levels were still higher in those diagnosed with FSGS, whereas the levels were not different between non-responders and responders. We plan to present additional results including urine specimen of same patients.

Funding

  • Commercial Support