Abstract: SA-PO691
The First-Year Course of Urine MCP-1 Is Associated With Response to the Initial Therapy and Long-Term Prognosis
Session Information
- Glomerular Diseases: Clinical, Outcomes, Trials - III
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials
Authors
- Pérez Arias, Abril A., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
- Macedo, Sofia E. Márquez, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
- Zavala Miranda, María Fernanda, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
- Cruz, Cristinoc, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
- Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
- Mejia-Vilet, Juan M., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico City, Mexico
Background
There is a need for useful biomarkers in lupus nephritis. The monocyte chemoattractant protein 1 (MCP-1) has been previously proposed as a biomarker of disease activity, however, it has been study at single timepoints and with short follow-up. We aimed o assess the course of uMCP-1 and its association with response to therapy and long-term kidney function in a prospective cohort of adults who received a kidney biopsy for suspicion of active lupus nephritis (LN).
Methods
Subjects were segregated into a histologically active LN group and a histologically chronic LN group. Both groups were followed for >36 months and urine were collected at flare, 3-, 6-, and 12-months of follow-up. The association between the course of uMCP-1, response to treatment, and progression to 30% loss of the eGFR was evaluated by linear mixed models for repeated measures.
Results
A kidney biopsy was performed on 125 subjects. In 114 the report was consistent with histologically active LN, and in 11 with chronic LN. Urine MCP-1 levels were significantly higher in the active LN than in the chronic LN group. Urine MCP-1 levels correlated with the histological findings of cellular crescents, endocapillary hypercellularity, interstitial inflammation, glomerular sclerosis, interstitial fibrosis, and tubular atrophy. The mean estimates of uMCP-1 at flare were higher in the non-response group than in the complete response group, and decreased in the complete/partial response groups by the 3rd month, while they remained elevated in the non-response group. The mean estimates for uMCP-1 were higher at LN flare and remained elevated in patients who progressed to loss of 30% of the eGFR, while they decreased in patients with stable kidney function.
Conclusion
The first-year course of uMCP-1 is associated with response to therapy and kidney survival in lupus nephritis.
Figure 1. First-year course of urine MCP-1 levels according to response to therapy (a) and long-term kidney prognosis (b).