#3657 Unveiling the role of peroxiredoxins 1–5 as markers in early diagnosis and monitoring of IgA nephropathy, membranous nephropathy and lupus nephritis

Abstract Background and Aims The early diagnosis of glomerulonephritis (GN) continue to present significant challenges in nephrology. Oxidative stress (OS) and its associated markers, particularly the peroxiredoxins (PRDXs), have been implicated in the pathophysiological mechanisms underlying several renal disorders. This study aimed to assess the clinical relevance of PRDXs 1–5 as diagnostic and prognostic biomarkers in patients with IgA nephropathy (IgAN), membranous nephropathy (MN) and lupus nephritis (LN) over a 7-year longitudinal follow-up. Method A cohort of 108 GN patients initially tested for abnormalities in serum concentrations of peroxiredoxins 1–5, was followed longitudinally over a 7-year period (2017–2024). The regular evaluations of renal function, including measurements of estimated glomerular filtration rate (eGFR) and timed proteinuria (TUP) at each in-person visit, were further analysed regarding to the change of PRDX concentration. The biomarker levels were re-evaluated in total of 25 patients (IgAN—14, LN—8, and MN—3). Statistical analysis was performed using the Wilcoxon, Mann Whitney-U or Kruskal-Wallis test, and Pearson's correlation coefficient, with significance level of P < 0.05. Results Serum levels of PRDXs 2–4 exhibited significant variability between measurements (2017 vs. 2023), whereas PRDX 1 and 5 remain on the similar level. However, upon analysing the relationship between PRDX levels and eGFR, significant differences were observed, specifically for PRDX 1 and 4 (P = 0.015 and P = 0.008) in relation to eGFR deterioration. TUP revealed the association (P = 0.01) with PRDX 1 only. The mean eGFR and proteinuria at the time of 2nd PRDX evaluation were: 67.12 ml/min/m2 and 1.17 g respectively. The deterioration of eGFR was predominantly observed in IgAN patients, although a doubling of serum creatinine was noted in only 4 of these patients. Conclusion This study highlights the clinical significance of PRDXs in the diagnostic and prognostic evaluation of glomerular diseases. We assume, that incorporating PRDX measurement (especially 1 and 4) into standard diagnostic protocols, could improve early detection of disease progression and facilitate personalized management of GN.