Work

Urinary RANTES and MCP-1 as noninvasive biomarkers for differential diagnosis and prediction of treatment response in acute interstitial nephritis

Year: 2024

Type: article

Abstract: Background: Although kidney biopsy is definitive for the diagnosis of acute interstitial nephritis (AIN) and acute tubular necrosis (ATN), its invasiveness limits its use. We aimed to identify urine biomarkers for differentiating AIN and ATN and to predict the response of patients with AIN to steroid treatment. Methods: = 55) were included. Urinary cytokine/chemokine [interleukin-9, monocyte chemoattractant protein-1 (MCP-1), regulated on activation, normal T cell expressed and secreted (RANTES), tumor necrosis factor-α, tumor growth factor-β and vascular endothelial growth factor] levels and the proportion of immune cells [expressing cluster of differentiation (CD)45, CD3, CD20] and proliferating tubular cells (expressing Ki-67) were analyzed by immunohistochemistry. Cytokine/chemokine levels and intrarenal immunohistochemistry data according to the response to steroid treatment in the AIN patients were also analyzed. Results: < .05 for all). Among steroid-administered patients with AIN, renal function improved significantly in the steroid responder group. These patients had higher urinary MCP-1/creatinine and intrarenal CD45 and Ki-67 levels than those in the non-responder group. Conclusions: The potential of the urinary RANTES/creatinine ratio as a noninvasive biomarker for differentiating AIN from ATN is highlighted. Urinary MCP-1/creatinine levels and the proportion of total intrarenal leukocytes and proliferating tubular cells may serve as indicators for predicting the response of patients with AIN to steroid treatment.

Source: Clinical Kidney Journal

DOI: 10.1093/ckj/sfae354