Abstract: TH-OR066
Associations Between Podocyte IgG and Risk of Relapse in Adult Diffuse Podocytopathy
Session Information
- Glomerular Diseases: Epidemiology and Real-World Outcomes
October 22, 2026 | Location: Room 501, Convention Center
Abstract Time: 04:50 PM - 05:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Wang, Qiyu, Mass General Brigham Inc, Boston, Massachusetts, United States
- Yu, Chenyang, Mass General Brigham Inc, Boston, Massachusetts, United States
- Ghasemi, Maryam, Mass General Brigham Inc, Boston, Massachusetts, United States
- Chadha, Ashima, Mass General Brigham Inc, Boston, Massachusetts, United States
- Avillach, Claire, Mass General Brigham Inc, Boston, Massachusetts, United States
- Shah, Sujal I., Mass General Brigham Inc, Boston, Massachusetts, United States
- Rubman, Mia B., Mass General Brigham Inc, Boston, Massachusetts, United States
- Alikhan, Firasat Mir, Mass General Brigham Inc, Boston, Massachusetts, United States
- Neinast, Michael B., UCLA Health, Los Angeles, California, United States
- Abdelnour, Lama Matni, UCLA Health, Los Angeles, California, United States
- Zuckerman, Jonathan E., UCLA Health, Los Angeles, California, United States
- Sekulic, Miroslav, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, United States
- Batal, Ibrahim, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, United States
- Kuruvada, Krishna Mohita, Northwell Health, New Hyde Park, New York, United States
- Ziemba, Yonah C., Northwell Health, New Hyde Park, New York, United States
- Wu, Ming, Northwell Health, New Hyde Park, New York, United States
- Jhaveri, Kenar D., Northwell Health, New Hyde Park, New York, United States
- Al Jurdi, Ayman, Mass General Brigham Inc, Boston, Massachusetts, United States
- Jeyabalan, Anushya, Mass General Brigham Inc, Boston, Massachusetts, United States
- Mount, David B., Mass General Brigham Inc, Boston, Massachusetts, United States
- Gupta, Shruti, Mass General Brigham Inc, Boston, Massachusetts, United States
- Weins, Astrid, Mass General Brigham Inc, Boston, Massachusetts, United States
Background
Punctate podocyte IgG has been identified as a tissue marker of anti-nephrin mediated injury in diffuse podocytopathy (DP). Podocyte IgG was associated with favorable response to immunosuppression (IS), but its relationship with relapse remains unclear.
Methods
We performed a retrospective multicenter cohort study in adults with newly diagnosed DP on native biopsy and ≥ 6 months of follow-up from 5 sites (MGH, BWH, Northwell, Columbia, UCLA). Concurrent active GN and advanced DN were excluded. Two pathologists independently evaluated podocyte IgG, and IgG-nephrin co-staining was performed on remnant tissue to resolve discrepancies. Kaplan-Meier analyses and multivariable Cox regression models were used to evaluate the associations between podocyte IgG and time-to-remission and time-to-relapse.
Results
In 176 included patients, 90 (51%) had podocyte IgG. Median age was 54 yrs (IQR 39—68), 46% were female, and 57% were White. Compared with those without podocyte IgG, patients with podocyte IgG had higher baseline UPCR (9.0 vs. 7.7 g/gm, P = 0.04) and lower serum albumin (1.9 vs. 2.3 g/dL, P < 0.001) (Table 1). In multivariable Cox regression models, podocyte IgG was associated with faster time-to-remission (HR 1.61, CI 1.13—2.3), whereas FSGS and arteriolar sclerosis was associated with slower response. Of the 168 patients who achieved at least partial remission, 75 (45%) relapsed and 35 (47%) of them had ≥ 2 relapses. Podocyte IgG was associated with earlier relapse (HR 1.85, CI 1.23—3.07, P = 0.02), with median time-to-relapse 142 days vs.170 days in those without podocyte IgG (Figure 1).
Conclusion
Podocyte IgG was associated with faster remission but also earlier relapse, suggestive of a distinct immunologic phenotype of anti-nephrin mediated DP.
Funding
- NIDDK Support