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Relationship between anti-GBM antibodies and kidney outcomes in patients with anti-GBM disease

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Abstract

Introduction

Animal experiments have shown that anti-GBM antibodies play a pathogenic role in anti-GBM disease. However, the relationship between anti-GBM antibody levels and kidney outcomes in patients with anti-GBM disease is unclear.

Methods

We performed a retrospective analysis of 110 patients diagnosed with anti-GBM disease. We compared their baseline characteristics stratifying on different anti-GBM antibody levels, and used Cox regression analysis to analyze the correlation between antibody levels and kidney survival. We further selected 69 patients to evaluate the modification of antibody titers over 14 days of treatment, then compared kidney survival of patients in the group with antibody level decrease < 48% to those with antibody decrease ≥ 48%.

Results

The 110 patients had a median follow-up of 27.1 (Q1–Q3: 7.9–80.1) months, and among them 90 (81.8%) developed kidney failure. Multivariate analysis suggested that anti-GBM antibody level was an independent risk factor for progression to kidney failure in patients with anti-GBM disease (HR 1.08, 95% CI 1.01–1.16). The patients who reduced the antibodies levels quickly had better kidney survival than those who did not, and multivariate analysis also indicated that antibody decrease rate was related to kidney outcomes.

Conclusions

Anti-GBM antibody level is closely related to kidney outcomes in patients with anti-GBM disease, and short-term reduction of antibodies can be beneficial to improving kidney outcomes.

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Availability of data and material

The datasets collected and analyzed in the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Key Research and Development Project of China (Grant number 2021YFC2501302).

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Authors and Affiliations

  1. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210016, China

    Mengyue Zhu, Jingjing Wang, Weibo Le, Feng Xu, Ying Jin, Chenfeng Jiao & Haitao Zhang

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  1. Mengyue Zhu
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  2. Jingjing Wang
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  4. Feng Xu
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  7. Haitao Zhang
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Correspondence to Haitao Zhang.

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All the authors declare no competing interests.

Ethical statement

This study was approved by the ethics committee of Jinling Hospital (2022DZKY-033-01), and was carried out following the principles of the Helsinki Declaration.

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Zhu, M., Wang, J., Le, W. et al. Relationship between anti-GBM antibodies and kidney outcomes in patients with anti-GBM disease. J Nephrol 36, 789–797 (2023). https://doi.org/10.1007/s40620-022-01508-5

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  • DOI: https://doi.org/10.1007/s40620-022-01508-5

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