Urine soluble CD163 as a biomarker of crescentic glomerulonephritis

Crescentic glomerulonephritis (CGN) is a severe form of kidney failure that leaves about one third of sufferers dependent on dialysis or needing a kidney transplant. It is currently difficult to assess the condition without performing a kidney biopsy, which is uncomfortable, expensive and occasionally dangerous to the patient. We have discovered that a protein present in kidneys of people with CGN, called CD163, is shed into the urine where it can be measured by a simple test. We have investigated this in a large group of people with one form of CGN (ANCA vasculitis) and found that the level of CD163 in the urine predicts accurately whether active CGN is present or not.
We now wish to bring this test closer to actual patient care by doing four things: 1) We will establish the test in the hospital setting 2) We will assess whether the test can diagnose a flare of ANCA vasculitis without needing a kidney biopsy. 3) We will measure the CD163 level in four separate sample collections around the world to see whether our findings hold true in other settings. 4) We will use the test to find out when the urine CD163 level disappears with treatment, which we hope will guide for how long that treatment is needed.
Taken together, these four strategies will place this new test in a position where it can be used in clinical practice. Apart from helping us diagnose CGN flare, we believe that this test will be useful in settings where access to the kidney biopsy or specialised blood tests is limited, such as in developing countries or rural areas. Here the test may assist in diagnosing CGN in the first place (rather than diagnosing a flare), which would greatly increase the number of people who could benefit from it.

Award Date

23 October 2015

Award Value

€329,767

Principal Investigator

Professor Mark Little

Host Institution

Trinity College Dublin

Scheme

Health Research Awards