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Shohei Tachibana, Masayuki Iyoda, Nobuhiro Kanazawa, Ken Iseri, Suzuki Taihei, Yukihiro Wada, Matsumoto Kei, Shibata Takanori, FP219
Clinical significance of serum and urinary uromodulin in ANCA-associated glomerulonephritis, Nephrology Dialysis Transplantation, Volume 34, Issue Supplement_1, June 2019, gfz106.FP219, https://doi.org/10.1093/ndt/gfz106.FP219Close - Share Icon Share
INTRODUCTION: Uromodulin (UMOD), also known as Tamm-Horsfall protein, is a kidney-specific protein expressed by epithelial cells lining the thick ascending limb of the loop of Henle. The current study aimed to clarify the clinical significance of UMOD in anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAG).
METHODS: Sixty-one biopsy-proven AAG patients were included in the study. UMOD was measured by ELISA.
RESULTS: Twenty-seven (44%), 19 (31%), 10 (16%), and 5 (8%) patients were classified into four histopathological classes as focal, crescentic, mixed, and sclerotic class. A negative correlation between serum UMOD and serum creatinine (P<0.001, r=-0.45) and positive correlation between serum UMOD and estimated glomerular filtration rate (eGFR) (P=0.002, r=0.39) were found. The levels of UMOD in serum and urine were closely correlated with each other (P=0.04, r=0.32). Patients in the higher group of serum UMOD levels (>156 ng/ml) were associated with lower creatinine (P=0.0073), the focal class in the histopathological classification of AAG (P<0.001) and mild tubulointerstitial injury group (P=0.016) compared to patients in the lower group. The cumulative proportions of renal survival at 10 years were 100%, 38%, 88%, and 80% for the focal, crescentic, mixed, and sclerotic class. In univariate Cox regression analyses, serum and urinary UMOD, and serum creatinine were associated with end-stage renal disease. For distinguishing severe histopathological classes (crescentic, mixed and sclerotic classes) from focal class, multivariate analyses were performed. Lower serum UMOD predicted severe histopathological classes independently renal function (P<0.001) and yielded a sensitivity of 70.6% and specificity of 90.0% (cut-off 143 ng/ml, area under the curve 0.80).
CONCLUSIONS: Lower serum UMOD level was associated with severe clinicopathological findings and might be considered as a risk factor of progressive renal dysfunction in AAG.
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