#2510 Biomarkers for predicting the efficacy of immunosuppressive therapy in IgA nephropathy: the role of serum MCP-1 and TGF-ß

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Abstract Background and Aims IgA nephropathy (IgAN) is the most common glomerulonephritis, with many patients progressing to end-stage kidney disease. Accurately predicting patient prognosis and treatment response is crucial for effective management. This study aims to identify key clinical factors and biomarkers that can predict immunosuppressive therapy outcomes in patients with IgAN. Method We conducted a retrospective study of adult patients with biopsy-proven IgAN diagnosed between 2010 and 2020. The study evaluated clinical and pathological variables, including serum and urine biomarkers (MCP-1, RANTES, TGF-beta, VEGF) and tissue CD45+ cell count. The outcome was Good prognosis defined as: urine protein to creatinine ratio (uPCR) ≥ 50% reduction or < 0.5 mg/mg, and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 or decrease < 5 mL/min/1.73 m2 at one-year post-biopsy. Results Mean age was 44.3 ± 12.7 versus 42.0 ± 13.3 years, eGFR 56.9 ± 29.4 versus 68.6 ± 30.7 mL/min/1.73 m2, and uPCR 2.1 ± 1.6 versus 1.6 ± 1.6 mg/mg in the control and Good prognosis groups, respectively. Good prognosis at one year was a reliable indicator of long-term renal prognosis. Predictors of Good prognosis included: high body mass index, absence of hypertension, high eGFR, low uPCR, low histologic grade, and immunosuppressive therapy. After adjusting for clinical and pathological variables, lower serum MCP-1 and higher serum TGF-β were associated with Good prognosis in patients receiving immunosuppressive therapy, but not in those with conservative treatment. CD4+ cell proportion did not correlate with Good prognosis in immunosuppressive therapy patients. Conclusion Immunosuppressive therapy was associated with good prognosis in patients with IgAN with serum MCP-1 and TGF-β potentially serving as biomarkers for treatment response. Further research is required to validate these preliminary results.

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