Abstract: SA-PO0933
Urinary Presepsin as a Biomarker for Inflammatory-Cell Infiltration in Kidney Diseases
Session Information
- Pathology: Updates and Insights
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Kawazoe, Tomohiro, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Tanaka, Akihito, Nagoya Daigaku Igakubu Fuzoku Byoin, Nagoya, Aichi Prefecture, Japan
- Furuhashi, Kazuhiro, Nagoya Daigaku Igakubu Fuzoku Byoin, Nagoya, Aichi Prefecture, Japan
- Kato, Noritoshi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Kosugi, Tomoki, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
- Maruyama, Shoichi, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan
Background
Kidney biopsy has long been the gold standard for diagnosing renal diseases. However, bleeding complications can disturb timely diagnosis. In clinical practice, there is an unmet need for diagnostic tools that can serve as alternatives to, or supplements for, kidney biopsy. Plasma presepsin (PSEP) is a well-known biomarker for early detection of sepsis. It is the N-terminal fragment of soluble CD14, which is expressed on granulocytes and monocytes and released into the bloodstream through phagocytosis. We hypothesized that urinary PSEP (uPSEP) may increase in renal inflammatory conditions.
Methods
This analytical cross-sectional study included patients registered in the Nagoya Kidney Disease Registry in 2020 and 2022. PSEP levels were measured using urine samples collected and cryopreserved at the time of kidney biopsy. Patients were classified according to biopsy-proven diagnoses and the association with uPSEP was evaluated. In addition, we assessed the association between uPSEP and the degree of inflammatory cell infiltration in the interstitium, graded as minimal (<5%), mild (5–25%), moderate (26–50%), or severe (>50%).
Results
A total of 543 patients (241 females and 302 males) with a median age of 59 years at the time of biopsy (IQR, 43–72 years) were included. The log-transformed uPSEP/creatinine (Cr) levels were compared among major renal diagnoses. Patients with tubulointerstitial nephritis (TIN) showed significantly higher levels compared to those with focal segmental glomerulosclerosis, IgA nephropathy, minimal change nephrotic syndrome, and membranous nephropathy. ROC analysis using uPSEP/Cr to detect TIN yielded the area under the curve (AUC) of 0.802 (95%CI, 0.741–0.862), with a cutoff value of 1526 ng/gCr. The AUC of uPSEP/Cr was significantly higher than that of urinary N-acetyl-β-D-glucosaminidase (NAG)/Cr (0.772 vs 0.491; P<0.001). When adjusted for confounding factors, the odds ratio for TIN-diagnosis per 1000-ng/gCr increase in uPSEP was 1.13 (95% CI, 1.02–1.25; P=0.0246). uPSEP/Cr levels were also significantly elevated in cases with more severe interstitial infiltration, with a significant trend confirmed by the Jonckheere-Terpstra test (P<0.001).
Conclusion
Urinary presepsin is a promising biomarker for detecting inflammatory cell infiltration in kidney.
Funding
- Commercial Support – PHC Holdings Corporation