Abstract: TH-PO0732
Anti-dsDNA Serological Status in Proliferative Lupus Nephritis
Session Information
- Glomerular Innovations: Artificial Intelligence, Multiomics, and Biomarkers
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Russo, Ilario, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Vargas-Brochero, Maria J., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Machado, Miriam, Mayo Clinic Minnesota Department of Laboratory Medicine and Pathology, Rochester, Minnesota, United States
- Castro, Pedro, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Berti, Gian Marco, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Cara, Anila, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Annese, Francesca, Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica, Bari, Apulia, Italy
- Sethi, Sanjeev, Mayo Clinic Minnesota Department of Laboratory Medicine and Pathology, Rochester, Minnesota, United States
- Zand, Ladan, Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
- Fervenza, Fernando C., Mayo Clinic Division of Nephrology and Hypertension, Rochester, Minnesota, United States
Background
A non-invasive biomarker of disease activity in Proliferative Lupus Nephritis is needed. We postulated that positive anti-dsDNA antibodies are a marker of immunological activity and can predict kidney biopsy (KBx) findings.
Methods
A retrospective cohort study of biopsy-proven Proliferative Lupus Nephritis (Class III-IV and Mixed Classes) from 01/2000 through 01/2024. Laboratory values were obtained at baseline (KBx).
Results
In a cohort of 148 patients with biopsy-proven Proliferative Lupus Nephritis, 146 patients (99%) had positive anti-dsDNA. In 9/146 (6%) of the patients, anti-dsDNA test was initially negative, but positive using an alternative assay, demonstrating that in a patient with a proliferative lupus nephritis, a false-negative result may occur if tested only by one method. In the 2 (1%) negative anti-dsDNA patients, serological status was tested with only 1 assay. Baseline clinical characteristics are shown in Table 1. A repeated KBx was performed 50 times in 39 patients. Median [IQR] time to repeat KBx was 60 [24,120] months. In 42/50 repeat KBx were done in the setting of positive anti-dsDNA, 8/50 in the setting of negative anti-dsDNA. In all but 1 patient, positive anti-dsDNA correlated with a Proliferative Lupus Nephritis on KBx (Table 2).
Conclusion
Anti-dsDNA positivity is omnipresent at the time of a Proliferative Lupus Nephritis diagnosis. In this setting, a negative test needs to be confirmed by a secondary assay. A repeated KBx confirmed the concordance of a proliferative lesion and positive serological status, marking it a potential biomarker for disease activity, precluding the need for a repeat KBx.