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Abstract: PO1731

Predictive Significance of Urinary CD11b and CD163 for the Renal Outcomes in ANCA-Associated Glomerulonephritis

Session Information

Category: Glomerular Diseases

  • 1202 Glomerular Diseases: Immunology and Inflammation

Authors

  • Tsuboi, Naotake, Department of Nephrology, Fujita Health University Graduate School of Medicine, Toyoake, Japan
  • Yokoe, Yuki, Department of Nephrology, Fujita Health University Graduate School of Medicine, Toyoake, Japan
  • Imaizumi, Takahiro, Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • Kitagawa, Akimitsu, Department of Nephrology, Fujita Health University Graduate School of Medicine, Toyoake, Japan
  • Maruyama, Shoichi, Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
Background

We hypothesized that the detection of leukocyte-derived CD11b (α subunit of integrin Mac-1) and CD163 (scavenger receptor) in urine may reflect renal inflammation and predict the renal outcomes in anti-neutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). The aim of this study was to evaluate the clinical significance of urinary CD11b (U-CD11b) and CD163 (U-CD163) as alternative noninvasive tests for ANCA-GN.

Methods

U-CD11b and U-CD163 levels were examined using ELISA in ANCA-GN urine samples from institutional cohort (n = 88) and a nationwide cohort (n = 138), and their association with renal histology were analyzed. Logistic regression analyses were performed on a nationwide ANCA cohort to determine the associations of the two urinary molecules with renal remission failure at 6 months or with yearly eGFR slope over a 24-month observation period.

Results

The significant elevations of U-CD11b and U-CD163 were observed in ANCA-GN patients histologically classified to the crescentic category. Histological analyses focusing on the distributions of CD11b+ or CD163+ leukocyte subsets in diseased glomeruli demonstrated dominant distribution of CD11b+ cells in undisrupted area than in glomerular crescent as contrasted with global distribution of CD163+ cells in diseased glomerulus. In addition, levels of U-CD11b and U-CD163 significantly correlated with crescent formation rate, respectively with CD11b+ cell and CD163+ cell number in glomerular crescents. Association analyses of both urinary molecules with post-treatment renal outcomes at 6 months after the treatment demonstrated that U-CD163 levels were significantly reduced and those at the time of diagnosis were already increased in patients who failed to remission or progressed renal insuficiency. Although these associations were not found in U-CD11b, analyses to determine the associations of the two urinary molecules and other clinical parameters with yearly impairment of renal function over a 24-month observation period demonstrated U-CD11b, but not U-CD163, at diagnosis as an independent factor predicting renal recovery.

Conclusion

Although both U-CD11b and U-CD163 reflect renal leukocyte accumulation, U-CD11b at diagnosis predicts the recovery rate after the treatment of ANCA-GN.

Funding

  • Government Support - Non-U.S.