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Abstract: SA-PO933

Urine sCD163/Creatinine Ratio Is a Potential Biomarker of Disease Severity in Patients with IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Tu, Kun-Hua, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
  • Tu, Yi-Ran, Chang Gung Memorial Hospital Linkou, Taoyuan, Taiwan
  • Wu, Tsai-yi, Chang Gung University, Taoyuan, Taoyuan, Taiwan
Background

IgA nephropathy is the most common glomerular disease in adults. There are several prediction model postulated for IgAN but no one could be validated successfully. In addition, no any one biomarker was proved to predict severity and survival for patients with IgA nephropathy. Recently, one urinary metabolite from macrophage, soluble CD163 (usCD163) was found remarkably elevated in patients with IgA nephropathy. Gong et al demonstrate urine sCD163/creatine ratio seems correlated to disease severity of IgA nephropathy. Thus, the investigator conducted a prospective study to elucidate the role of urine sCD163/creatinine in IgA nephropathy.

Methods

The investigators initiated a prospective cohort of glomerular disease at a tertiary medical center in Taiwan. Mid-stream spot urine sample was prospectively obtained before renal biopsy. During the study period, there are 150 subjects with pathologic diagnosis of IgA nephropathy. After exclusion as criteria, there are totally 70 subjects believed as primary IgA nephropathy was studied. Pre-stored urine sample were used to check the level of soluble CD163 and creatinine.

Results

The level of urine soluble CD163/creatinine could be devided into 3 tertiles. Between these tertiles, there are no remarkable difference in serum creatinine and GFR. Greater tertiles of usCD163/Cr have greater severitiy of hypoalbuminemia, proteinuria, hypercholesterolemia and hypertension. Greater tertiles of usCD163/Cr have also more obsoleted glomeruli, greater severity of tubulointerstitial fibrosis, and more crescents formation. ≥ 50% decline of estmitaed glomerular filtration rate (eGFR) and entering dialysis during study period didn't achieve stastistical difference between 3 tertiles of usCD163/Cr. Survival analysis toward ≥ 50% eGFR deline and entering dialysis, however, revealed lower survival probability in tertile 3 compared to tertile 1+2.

Conclusion

Urine sCD163/creatinine ratio seems correlated to proteinuria and the symptoms associated with nephrosis. It also correlated to histologic injury of glomerular sclerosis and tubulointerstitial fibrosis. Although there are no stastistical significance of ≥ 50% eGFR decline and entering dialysis between these tertiles, survival analysis proved that lower survival probability in tertile 3 compared to tertile 1+2.