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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Soc+Nephrol
2016 ; 27
(9
): 2906-16
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Urinary Soluble CD163 in Active Renal Vasculitis
#MMPMID26940094
O'Reilly VP
; Wong L
; Kennedy C
; Elliot LA
; O'Meachair S
; Coughlan AM
; O'Brien EC
; Ryan MM
; Sandoval D
; Connolly E
; Dekkema GJ
; Lau J
; Abdulahad WH
; Sanders JS
; Heeringa P
; Buckley C
; O'Brien C
; Finn S
; Cohen CD
; Lindemeyer MT
; Hickey FB
; O'Hara PV
; Feighery C
; Moran SM
; Mellotte G
; Clarkson MR
; Dorman AJ
; Murray PT
; Little MA
J Am Soc Nephrol
2016[Sep]; 27
(9
): 2906-16
PMID26940094
show ga
A specific biomarker that can separate active renal vasculitis from other causes
of renal dysfunction is lacking, with a kidney biopsy often being required.
Soluble CD163 (sCD163), shed by monocytes and macrophages, has been reported as a
potential biomarker in diseases associated with excessive macrophage activation.
Thus, we hypothesized that urinary sCD163 shed by crescent macrophages correlates
with active glomerular inflammation. We detected sCD163 in rat urine early in the
disease course of experimental vasculitis. Moreover, microdissected glomeruli
from patients with small vessel vasculitis (SVV) had markedly higher levels of
CD163 mRNA than did those from patients with lupus nephritis, diabetic
nephropathy, or nephrotic syndrome. Both glomeruli and interstitium of patients
with SVV strongly expressed CD163 protein. In 479 individuals, including patients
with SVV, disease controls, and healthy controls, serum levels of sCD163 did not
differ between the groups. However, in an inception cohort, including 177
patients with SVV, patients with active renal vasculitis had markedly higher
urinary sCD163 levels than did patients in remission, disease controls, or
healthy controls. Analyses in both internal and external validation cohorts
confirmed these results. Setting a derived optimum cutoff for urinary sCD163 of
0.3 ng/mmol creatinine for detection of active renal vasculitis resulted in a
sensitivity of 83%, specificity of 96%, and a positive likelihood ratio of 20.8.
These data indicate that urinary sCD163 level associates very tightly with active
renal vasculitis, and assessing this level may be a noninvasive method for
diagnosing renal flare in the setting of a known diagnosis of SVV.
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