Kidney Week

Abstract: TH-OR067

Urinary CD93 Is a Predictor of Kidney Disease Progression Across Glomerular Diseases: A CureGN Study

Session Information

• Glomerular Diseases: Epidemiology and Real-World Outcomes
  October 22, 2026 | Location: Room 501, Convention Center
  Abstract Time: 05:00 PM - 05:10 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Annesi, Lorenzo, Nationwide Children's Hospital, Columbus, Ohio, United States

Lorenzo Annesi, MD

• Robinson, Cal, Sick Kids Foundation, Toronto, Ontario, Canada

Cal Robinson, MBChB, PhD, FASN

• Islam, Md Imtiazul, Nationwide Children's Hospital, Columbus, Ohio, United States

Md Imtiazul Islam, PhD

• Fetsko, Audrey Rose, Nationwide Children's Hospital, Columbus, Ohio, United States

Audrey Rose Fetsko, PhD

• Nargis, Nelofar, Nationwide Children's Hospital, Columbus, Ohio, United States

Nelofar Nargis, PhD

• Muralidharan, Kaushik, Nationwide Children's Hospital, Columbus, Ohio, United States

Kaushik Muralidharan, MS, PhD

• Phillips, Melonie Anne, Nationwide Children's Hospital, Columbus, Ohio, United States

Melonie Anne Phillips, MD

• Kallash, Mahmoud, Nationwide Children's Hospital, Columbus, Ohio, United States

Mahmoud Kallash, MD

• Johnson, Richard J., University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States

Richard J. Johnson, MD

• Cara-Fuentes, Gabriel M., Nationwide Children's Hospital, Columbus, Ohio, United States

Gabriel M. Cara-Fuentes, MD, PhD

Background

Urinary CD93 (uCD93) has emerged as a candidate marker of endothelial injury in glomerular diseases. Here, we aimed to test whether uCD93 may predict long-term kidney outcomes across glomerulopathies.

Methods

By ELISA, we measured uCD93 levels (adjusted to urine creatinine) in a single urine sample from 1616 children and adults with biopsy-proven glomerular disease enrolled in the CureGN study (MCD=423, FSGS=379, MN=399, IgAN/IgAV=415 and from 55 healthy controls. 797 patients were in complete remission (urine protein-to-creatinine ratio [UPCR] <0.3g/g). Correlation was used to test association between uCD93 with proteinuria and estimated glomerular filtration rate (eGFR). Time-to-event analyses were performed using Cox-proportional hazards models and Kaplan-Meier plots adjusted to age, sex, race, eGFR, UPCR and immunosuppressive use. Kidney outcomes were time to complete remission, time to 40% eGFR decline, and time to kidney failure (eGFR<15 ml/min/1.73 m2, dialysis or transplantation).

Results

Across glomerular diseases, patients with proteinuria showed higher uCD93 than those without proteinuria (p<0.001). UCD93 correlated positively with proteinuria and inversely with eGFR (p<0.001). In patients with proteinuria, a higher uCD93 was associated with longer time to achieve remission, regardless of the underlying histological diagnosis (adjusted HR=0.51 [0.37-0.71], p<0.001). Across all patients, regardless of diagnosis or proteinuria, uCD93 was strongly associated with time to 40% eGFR decline (HR=4.73 [3.43-6.52], p<0.001, Figure 1) and time to kidney failure (HR=13.87 [6.45-29.80], p<0.001).

Conclusion

High urinary CD93 is associated with kidney disease progression regardless of proteinuria and histological diagnosis.

Funding

• NIDDK Support