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

Publication date: Available online 5 October 2018

Source: Clinical Immunology

Author(s): Kunihiro Ichinose, Mineaki Kitamura, Shuntaro Sato, Keita Fujikawa, Yoshiro Horai, Naoki Matsuoka, Masahiko Tsuboi, Fumiaki Nonaka, Toshimasa Shimizu, Shoichi Fukui, Masataka Umeda, Tomohiro Koga, Shin-ya Kawashiri, Naoki Iwamoto, Takashi Igawa, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Tomoya Nishino, Atsushi Kawakami

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.

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