Kidney Week

Abstract: SA-OR009

Urinary CXCL9 as a Predictive Biomarker of Corticosteroid Responsiveness in Acute Tubulointerstitial Nephritis

Session Information

• AKI Advances: Biomarkers, Outcomes, and Clinical Trials
  November 08, 2025 | Location: Room 320A, Convention Center
  Abstract Time: 05:50 PM - 06:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Sadarangani, Sagar S., Yale School of Medicine, New Haven, Connecticut, United States

Sagar S. Sadarangani, MBBS

• Obeid, Wassim, Johns Hopkins Medicine, Baltimore, Maryland, United States

Wassim Obeid, PhD

• Moeckel, Gilbert W., Yale School of Medicine, New Haven, Connecticut, United States

Gilbert W. Moeckel, MD, PhD, FASN

• Kuperman, Michael Benjamin, Cleveland Clinic, Cleveland, Ohio, United States

Michael Benjamin Kuperman, MD

• Kumar, Deepika, Yale School of Medicine, New Haven, Connecticut, United States

Deepika Kumar, MD

• Rosenberg, Avi Z., Johns Hopkins Medicine, Baltimore, Maryland, United States

Avi Z. Rosenberg, MD, PhD

• Perazella, Mark A., Yale School of Medicine, New Haven, Connecticut, United States

Mark A. Perazella, MD, MS, FASN

• Turner, Jeffrey M., Yale School of Medicine, New Haven, Connecticut, United States

Jeffrey M. Turner, MD

• Luciano, Randy L., Yale School of Medicine, New Haven, Connecticut, United States

Randy L. Luciano, MD, PhD

• Parikh, Chirag R., Johns Hopkins Medicine, Baltimore, Maryland, United States

Chirag R. Parikh, MD, PhD, FASN

• Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States

Dennis G. Moledina, MD, PhD, FASN

Background

Acute tubulointerstitial nephritis (ATIN) requires targeted management including corticosteroid therapy, which has significant adverse events. Identifying those who may benefit from corticosteroid therapy will advance the goal of personalized medicine in ATIN. Here we test the utility of urinary C-X-C motif ligand 9 (CXCL9) as a biomarker to assess steroid responsiveness in patients with ATIN.

Methods

In 51 participants with biopsy proven, pathologist adjudicated ATIN we tested the urinary CXCL9 measured at the time of biopsy as a predictive biomarker of steroid responsiveness by testing the interaction of CXCL9×corticosteroid use in a linear regression model for the outcome of estimated glomerular filtration rate measured 6 months after ATIN diagnosis (6 m-eGFR) controlling for eGFR before ATIN and degree of intertstitial fibrosis and tubular atrophy.

Results

While corticosteroid use was not associated with 6-month eGFR in the overall cohort [diff in eGFR between steroids vs. not, 11.1 (-3.5, 25.7) mL/min/1.73 m², p=0.13], we noted differential effect of corticosteroid use on 6 m-eGFR (interaction P= 0.01) such that corticosteroid use was associated with higher 6m eGFR only in those with the highest level of urine CXCL9 at ATIN diagnosis (48.0 (12.8, 83.2)).

Conclusion

Corticosteroid use was associated with higher eGFR after ATIN only in those with high urinary CXCL9 but not in others. These findings indicate the potential of urinary CXCL9 as a predictive biomarker of steroid responsiveness in ATIN.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20258762wsmf