Macrophage in Lupus Nephritis: Can It Be a Predictor of Treatment Response?
B Cheunsuchon, P Incharoen, T Chanchairujira, C Shayakul. Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background: Patients with lupus nephritis class IV who responded to treatment within 6 months had better renal outcome than those who did not. Although parameters such as race, pathologic classification and chronicity index have been associated with treatment response and/or remission, there is currently no information regarding which clinicopathologic parameters can predict treatment response. Glomerular macrophage is known to be associated with clinical parameters indicating poor renal outcome such as higher serum creatinine and proteinuria. The objective of study is to evaluate whether glomerular macrophage number can be used to predict response to treatment in patients with lupus nephritis class IV.
Design: Renal biopsies (N = 92, 88 female) diagnosed with lupus nephritis class IV according to International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 were included in the study. The patients were divided into 2 groups according to response to treatment within 6 months. The treatment response group was defined as having decreased serum creatinine and 24 hr urine protein or UPCR (urine protein creatinine ratio) < 1. The non-response group was defined as stable or increased serum creatinine and/or 24 hr urine protein/or UPCR ≥ 1. There were 46 patients in response group and 46 in non-response group. Immunohistochemistry for macrophage marker (CD68) was performed and the glomerular macrophages were counted on each biopsy. The clinicopathologic parameters were collected including serum creatinine, UPCR and/or 24 hr urine protein at the biopsy time, histologic activity and chronicity indices.
Results: The glomerular macrophage number in response and non-response group was 4.55 + 2.47 and 6.13 + 2.51 respectively (p=0.04). The glomerular macrophage number was inversely correlated with chronicity index, r = -0.372 and P < 0.001.
Conclusions: Patients with lupus nephritis class IV who responded to treatment within 6 months had less glomerular macrophages than than those who did not. The glomerular macrophage number may be used to predict treatment response in lupus nephritis class IV patients.
Category: Kidney (does not include tumors)
Wednesday, March 24, 2010 1:00 PM
Poster Session VI # 240, Wednesday Afternoon