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Pre-Transplant Angiotensin Receptor II Type 1 Antibodies (AT1R) and Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) as Predictors of Post Transpalnt FSGS Recurrence

A. Khalil, T. Tim, A. Sharfuddin, S. Doshi, M. Yaqub, D. Mishler, W. Goggins, M. Mujtaba.

Indiana University school of Medicine-IU Health Transplant, Indianapolis, IN.

Meeting: 2015 American Transplant Congress

Abstract number: 358

Keywords: Recurrence, Renal dysfunction, Risk factors

Session Information

Session Name: Concurrent Session: Glomerulonephritis/Recurrent Disease

Session Type: Concurrent Session

Date: Tuesday, May 5, 2015

Session Time: 2:15pm-3:45pm

 Presentation Time: 2:39pm-2:51pm

Location: Room 121-AB

Approximately 30% of renal transplant patients develop recurrence of FSGS in the first kidney allograft. AT1R is expressed on podocytes; its expression is elevated in the proteinuric state. This prompted us to test the pre-transplant sera of patients with history of biopsy proven FSGS for AT1R antibody levels along and serum soluble urokinase-type plasminogen activator receptor (suPAR) as a biomarker for risk of recurrence of FSGS after transplant.

Methods: Pre-transplant sera of 39 patients (FSGS 28, polycystic kidney disease [PKD] 11 as controls) were collected and stored at -80oC until testing in batch for anti-AT1R and suPAR under an IRB approved protocol. AT1R antibody and suPAR levels were measured using ELISA (One Lambda®, Canoga Park, CA) and suPAR ELISA kit.

Results: Twelve patients had biopsy proven post-transplant FSGS recurrence at 1.5 months. No difference was found in the pre-transplant suPAR levels of FSGS patients (5993±2292pg./mL)vs.PKD (7334±4538pg./mL),(p= 0.23)..Serum suPAR levels in patients with FSGS recurrence (5786±1899pg./mL) vs. no FSGS recurrence(6149±2598pg./mL)(p= 0.69) were not different.. Mean AT1R antibody levels in patients with FSGS were 12.66±11.85 U/mL vs. 8.69±6.52 U/mL in PKD (p= 0.32), however, a difference was found in patients with 20.41±14.36 U/ml and without FSGS recurrence 6.84±4.181 U/mL (p<0.01). Area under curve for suPAR and AT1R to predict post-transplant FSGS recurrence was 0.51 and 0.84 respectively.

Conclusion: Pre-transplant anti-AT1R antibody levels appear to be a helpful biomarker in identifying patients at high risk of post-transplant FSGS recurrence. More studies are needed to confirm our findings.

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To cite this abstract in AMA style:

Khalil A, Tim T, Sharfuddin A, Doshi S, Yaqub M, Mishler D, Goggins W, Mujtaba M. Pre-Transplant Angiotensin Receptor II Type 1 Antibodies (AT1R) and Serum Soluble Urokinase-Type Plasminogen Activator Receptor (suPAR) as Predictors of Post Transpalnt FSGS Recurrence [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-transplant-angiotensin-receptor-ii-type-1-antibodies-at1r-and-serum-soluble-urokinase-type-plasminogen-activator-receptor-supar-as-predictors-of-post-transpalnt-fsgs-recurrence/. Accessed May 10, 2025.

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