Podocyte foot process width is a prediction marker for complete renal response at 6 and 12 months after induction therapy in lupus nephritis

Clin Immunol. 2018 Dec:197:161-168. doi: 10.1016/j.clim.2018.10.002. Epub 2018 Oct 5.

Abstract

Morphological change that includes diffuse effacement of podocyte foot processes is correlated with proteinuria in patients with lupus nephritis (LN). We collected the data of clinico-pathological parameters and assessed foot process width (FPW) as an index of podocyte effacement in 73 patients with LN who had undergone renal biopsy. The multivariate analysis revealed that female gender (OR: 5.288; 95%CI: 1.197-37.29; p = .0267) and FPW (OR = 0.999, 95%CI = 0.997-0.999, p = .0150) were significantly predictive of a complete renal response (CR) at 6 months, while lymphocyte counts (OR = 1.002; 95%CI = 1.001-1.003, p = .0028) and FPW (OR = 0.998, 95%CI = 0.996-0.999, p = .0027) were significantly predictive of CR at 12 months. The cut-off point determined by the Classification and Regression Trees algorithm showed that FPW <908.3 nm provides the best performance for predicting patients who achieve CR at 12 months. A smaller FPW appears to be a predictive factor for CR at 6 and 12 months after induction therapy.

Keywords: Complete renal responses; Foot process width; Lupus nephritis; Podocyte.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Creatinine / urine
  • Cyclophosphamide / therapeutic use
  • Cyclosporine / therapeutic use
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Logistic Models
  • Lupus Nephritis / drug therapy*
  • Lupus Nephritis / pathology
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Multivariate Analysis
  • Mycophenolic Acid / therapeutic use
  • Podocytes / ultrastructure*
  • Prednisolone / therapeutic use
  • Prognosis
  • Proteinuria
  • Remission Induction
  • Retrospective Studies
  • Severity of Illness Index
  • Tacrolimus / therapeutic use

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclosporine
  • Cyclophosphamide
  • Prednisolone
  • Creatinine
  • Mycophenolic Acid
  • Tacrolimus
  • Methylprednisolone