Abstract: TH-PO0723
Following the usCD163 Path to Remission in Acute ANCA-Associated Vasculitis (AAV) with Kidney Involvement
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
- Anwari, Kashif Jamil, University College London, London, England, United Kingdom
- Antonelou, Marilina, University College London, London, England, United Kingdom
- Evans, Rhys, University College London, London, England, United Kingdom
- Salama, Alan D., University College London, London, England, United Kingdom
Background
In acute renal-involving ANCA-associated vasculitis (rAAV), we monitor several inaccurate or slowly responsive traditional biomarkers to reflect dynamic inflammatory changes. Protocolized induction immunosuppression (IS) is thus delivered, likely subjecting patients to under/over treatment. Urinary soluble CD163 (usCD163) is a novel biomarker that can delineate active rAAV from remission but it's temporal trends require clarification. We longitudinally profiled usCD163, and compared it with IS received and normalization of traditional biomarkers.
Methods
Adult patients with acute rAAV were recruited and followed up for 1 year. At baseline and then at 1–2-month intervals, traditional biomarkers were recorded (haematoproteinurea, serum creatinine, C-reactive protein, PR3/MPO autoantibodies, disease activity scores). usCD163 was quantified using a commercial ELISA kit (DuoSet DY1607; R&D systems), normalized to urine creatinine (usCD163:Cr) and assessed for positivity based on a previously described cutoff of 250ng/mmol by Moran et al.
Results
11 patients (5 males, 6 white) were recruited with a mean age (SD) of 60 (5) years. Clinical information is presented in Figure 1. Patients were studied for a median (IQR) of 256 (198-363) days. The median (IQR) time to peak and achieve negativity of usCD163 was 0 (0-16) and 77 (28-149) days, respectively. Induction IS received by time of usCD163 negativity varied from 1-2 rituximab +/- 1-5 cyclophosphamide infusions. usCD163 negativity predated median time to normalization of all traditional biomarkers.
Conclusion
Variations exist in time and IS required to achieve usCD163 negativity in acute rAAV patients and this biomarker seems to predate normalization of all traditional biomarkers of renal remission. Improving confidence of declaring remission in rAAV to guide personalised induction IS may be achieved by correlating usCD163 with other promising biomarkers such as urinary T lymphocytes and urinary CD25.