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AB0348 (2021)
ALBUMIN-TO-GLOBULIN RATIO AS A POTENTIAL PREDICTOR OF RENAL REMISSION IN LUPUS NEPHRITIS
T. Knežević1, I. Padjen2, S. Bulimbašić3, M. Ćorić3, V. Ivković1, M. Laganović4, B. Anić2
1University Hospital Centre Zagreb, Division of Nephrology, Hypertension, Dialysis and Transplantation, Department of Internal Medicine, ZAGREB, Croatia
2University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia, Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, ZAGREB, Croatia
3University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia, Department of Pathology and Cytology, University Hospital Centre Zagreb, Croatia, ZAGREB, Croatia
4University Hospital Centre Zagreb and University of Zagreb, School of Medicine, Zagreb, Croatia, Division of Nephrology, Hypertension, Dialysis and Transplantation, National Referral Centre for Glomerular and Tubulointerstitial Diseases, Zagreb, Croatia, ZAGREB, Croatia

Background: Optimal prognostic predictors in lupus nephritis (LN) are still not clearly defined. Studies have recently shown that albumin-to-globulin ratio (A/G) is not only a good predictor of outcomes in malignancy, infection and renal disease, but is also a potential marker of increased immunoglobulin synthesis and LN activity and might be useful as a predictor of the development of LN in SLE patients. Studies on the role of A/G in predicting outcomes in LN are, however, lacking.


Objectives: To assess a potential prognostic value of A/G at renal biopsy in predicting outcomes in LN.


Methods: In this retrospective study we analyzed the demographic, histologic, laboratory and clinical characteristics of patients with biopsy-proven LN diagnosed between 2011 and 2020. All patients met the 1997 revised American College of Rheumatology classification criteria for SLE. Complete remission was defined as proteinuria <0.5 g/day and serum creatinine within 10% from baseline, and partial remission as more than 50% reduction in proteinuria to sub-nephrotic levels and serum creatinine within 10% from baseline.


Results: We have included 55 patients (80% women) with biopsy-proven LN (age at biopsy 38±13 years). On renal histology, one patient was class I LN, two patients were class II, 7 were class III, 5 were class III+V, 23 were class IV, two were class IV+V, 11 class VI and 4 had other features. Median eGFR and proteinuria at biopsy were 69 (IQR: 44, 100) mL/min/1.73 m 2 and 3.5 (2.3, 5.6) g/day, respectively. Baseline mean A/G was 1.12±0.29 and did not differ between LN classes (p=0.91). At one-year follow-up eGFR increased non-significantly (69 vs. 82 mL/min/1.73 m 2 , p=0.13) and proteinuria decreased (3.5 vs. 0.6 g/day, p<0.001). Eighteen patients achieved complete remission (CR), 16 partial remission and 21 did not achieve remission. None progressed to ESRD and two patients died, both from sepsis. A/G at the time of biopsy did not differ between group which achieved CR/PR vs. no remission (p>0.05; Figure 1 ) and was not a significant predictor of remission in a multivariate regression model (OR 5.9, 95% CI 0.6, 63.2).


Conclusion: While being a potential marker for transition of SLE to LN, A/G was not showed to be a predictor of renal remission in LN.


REFERENCES:

[1]Liu XR, et al. Lupus. 2021 Jan 6:961203320981139.

[2]Kwon OC, et al. Semin Arthritis Rheum. 2018 Dec;48(3):462-466ck


Disclosure of Interests: None declared

Citation: Ann Rheum Dis, volume 80, supplement 1, year 2021, page 1199
Session: SLE, Sjögren’s and APS - clinical aspects (other than treatment) (Publication Only)