Kidney Week

Abstract: TH-PO0493

A Proliferation-Inducing Ligand (APRIL), B-Cell-Activating Factor (BAFF), and Urinary CD163 Are Associated with Composite Kidney Outcomes Across Diverse Glomerular Disease Phenotypes

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - IgAN
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Vasquez-Rios, George, Renal Medicine Associates, Albuquerque, New Mexico, United States

George Vasquez-Rios, MD, MSCR, FASN

• Mosoyan, Gohar, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Gohar Mosoyan, MS

• Tokita, Joji E., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Joji E. Tokita, MD

• Meliambro, Kristin, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Kristin Meliambro, MD

• Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Steven G. Coca, DO, MS

Background

Kidney function decline in glomerular diseases is heterogeneous, and proteinuria and eGFR incompletely capture underlying biology. Immune dysregulation and macrophage-driven inflammation contribute to progression; however, integrated evaluation of APRIL, BAFF, and uCD163 across phenotypes remains limited.

Methods

We evaluated associations between APRIL, BAFF, and urinary CD163 concentrations and adverse kidney outcomes across IgAN, FSGS, and DKD. We performed a retrospective biomarker analysis using samples and linked clinical data from the BioMe Mount Sinai Biorepository. The composite kidney outcome included eGFR <15 mL/min, HD initiation, or kidney transplantation. APRIL, BAFF, and urinary CD163 concentrations were measured using electrochemiluminescence-based MSD/U-PLEX assays. Biomarker associations with kidney outcomes were evaluated descriptively using biomarker distributions and APRIL tertile analyses.

Results

A total of 105 patients were included (FSGS n=43, IgAN n=37, DKD n=25). Overall, 44 patients (41.9%) experienced the composite kidney outcome. Event rates differed by diagnosis: DKD 68.0%, FSGS 41.9%, and IgAN 24.3%. Baseline kidney function and proteinuria reflected a high-risk population (mean eGFR 46.4 mL/min; mean UPCR 4.79 g/g). Patients experiencing the composite kidney outcome had lower baseline eGFR (28.4 vs 59.5 mL/min) and higher proteinuria (6.98 vs 3.16 g/g) compared with those without events. Median time-to-event differed across disease phenotypes (DKD 270 days; FSGS 682.5 days; IgAN 1460 days). Multiplex assays demonstrated excellent analytical performance with recovery rates of 103% for urinary CD163, 97% for APRIL, and 102% for BAFF. APRIL demonstrated the strongest association with adverse kidney outcomes. In IgAN, composite kidney outcome rates increased across APRIL tertiles from 8.3% to 25.0% and 41.7%, while in FSGS rates increased from 14.3% to 28.6% and 80.0%, respectively. Patients with DKD and adverse kidney outcomes also demonstrated higher APRIL concentrations, although variability was greater. BAFF and urinary CD163 showed a mild trend among patients with kidney events.

Conclusion

APRIL, BAFF, and urinary CD163 concentrations can be reliably measured using multiplex MSD/U-PLEX platforms. Elevated APRIL concentrations were associated with composite kidney outcomes across IgAN, FSGS, and DKD.