Patients with primary focal segmental glomerulosclerosis with detectable urinary CD80 are more similar to patients with minimal change disease in clinicopathological features

• Published in: Renal failure Vol. 45; no. 2; p. 2279642
• Main Authors: Gong, Xiaojie, Huang, Jing, Zhang, Yimiao, Wang, Fang, Wang, Xin, Meng, Liqiang, Cheng, Xuyang, Liu, Gang, Cui, Zhao, Zhao, Minghui
• Format: Journal Article
• Language: English
• Published: New York Taylor & Francis Ltd 2023; Taylor & Francis Group
• Subjects: Biopsy; CD80 antigen; Creatinine; Hematuria; mild pathological change; Multivariate analysis; Nephrotic syndrome; Patients; primary focal segmental glomerulosclerosis; Proteinuria; Risk factors; severe clinical manifestations; steroid-dependent; Steroids; Urinary CD80
• ISSN: 0886-022X; 1525-6049
• DOI: 10.1080/0886022X.2023.2279642

BackgroundFocal segmental glomerulosclerosis (FSGS) is an important cause of refractory nephrotic syndrome (NS) in children and adults. Urinary CD80 is elevated in some patients with primary FSGS, however, its clinical value is not fully clarified. This study aims to evaluate the clinical and pathological significance of urinary CD80 in patients with primary FSGS.MethodsSixty-one adult patients with biopsy-proven primary FSGS, with standard treatment and long-term follow up, were enrolled retrospectively. Urinary CD80, on the day of kidney biopsy, was measured using commercial ELISA kits and adjusted by urinary creatinine excretion. Their associations with clinical and pathological parameters were investigated.ResultsUrinary CD80 was detectable in 30/61 (49.2%) patients, who presented with a higher level of proteinuria (10.7 vs. 5.8 g/24h; p = 0.01), a lower level of serum albumin (19.3 ± 3.9 vs. 24.2 ± 8.2 g/L; p = 0.005), a higher prevalence of hematuria (70.0 vs. 38.7%; p = 0.01), and showed a lower percentage of segmental glomerulosclerosis lesion [4.8 (3.7–14.0) vs. 9.1 (5.6–21.1) %; p = 0.06]. The cumulative relapse rate was remarkably high in these patients (log-rank, p = 0.001). Multivariate analysis identified that the elevated urinary CD80 was an independent risk factor for steroid-dependent NS (OR 8.81, 95% CI 1.41–54.89; p = 0.02) and relapse (HR, 2.87; 95% CI 1.29–6.38; p = 0.01).ConclusionsThe elevated urinary CD80 is associated with mild pathological change and steroid-dependent cases of primary FSGS adults, which indicates these patients are more similar to minimal change disease (MCD) in clinicopathological features.