10, 52% of cases. Hyperuricemia was observed in 47, 36% of cases. Hepatic cytolysis was showed in 26, 31% of cases. The etiologies of ARF in pregnancy were dominated by acute tubular necrosis in 42.10% of cases, thrombotic microangiopathy in 15, 78% of cases, retro placental hematoma in 10, and 52% of cases. Hemorrhagic shock was noted in 10, 52 % of cases. Renal biopsy was performed in 52.63% of cases, finding acute tubular necrosis in 26, 31 %, a thrombotic microangiopathy in 10, 52%, crescentic glomerulonephritis type III in 15,79 %, both acute tubular necrosis and cortical necrosis in 10,52% and both acute tubular necrosis with diabetic nephropathy in 10,52 % of cases. Recourse to extra renal therapy in the form of intermittent hemodialysis was observed in 52, 63 % of cases. The average number of hemodialysis sessions was 3. The use of exchanges plasmatic was noted in 26, 31% of cases. The evolution is marked by improvement of renal function in 26.31% of cases, and 31.57% of patients progressed to ESRD while 47.4% remained a chronic kidney disease with a mean clearance to 30,14ml/min (15-46 ml /min). Maternal mortality was noted in 5.26% related to pulmonary embolism. Perinatal fetal mortality was observed in 57.9%. CONCLUSIONS: In developing countries, pregnancy-related acute renal failure remains a frequent and grave complication. It reflects the absence of prenatal care and early detection of high-risk pregnancies, the delay in transfer of patients and the pauc- ity of relevant human and material resources. It is certainly a treatable and curable complication, but one that imposes a heavy burden of maternal morbidity and mortal- ity if its diagnosis and treatment are delayed. The best treatment remains prevention, a goal very difficult to attain in these developing countries, to target women in labor at high risk, and optimize their management, to reduce the incidence of ARF gestational. MP190 CLINICAL DETERMINANTS OF RENAL OUTCOMES IN DRUG- INDUCED ACUTE INTERSTITIAL NEPHRITIS Fernando Caravaca-Fontan 1 , Javier Villacorta 2 , Alfredo Cordon 2 , Manuel Praga 1 , Gema Fern andez-Ju arez 2 , omerular Diseases (GLOSEN) On Behalf of the Spanish Group for the Study of Gl 1 Nephrology Hospital Universitario 12 De Octubre Madrid Spain and 2 Nephrology Hospital Universitario Fundaci on Alcorc on Madrid Spain INTRODUCTION AND AIMS: Drug-induced acute interstitial nephritis (DI-AIN) represents an emerging cause of acute kidney injury, especially among polymedicated elderly patients. Some studies suggest that early treatment with corticosteroids (CS) may be beneficial for renal recovery. However, less is known about the optimal dura- tion of this therapy. This study aims to investigate clinical predictors of renal outcomes in patients with DI-AIN treated with CS. METHODS: Multicenter, retrospective, observational study in 13 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). Patients with biopsy proven DI-AIN treated with CS between 1996-2016 were included. Other potential causes of AIN such as infections or systemic diseases were carefully ruled out. Clinical, biochemical and histologic parameters of prognostic interest were recorded and used to characterize patients with complete renal recovery (CRR), partial recovery (PR) (loss of <50% estimated glomerular filtration rate (eGFR)) or no recovery (NR) (loss of >50% eGFR). RESULTS: The study group consisted of 203 patients (mean age 66614 years, 50% male). The classic triad of rash, fever and eosinophilia was only found on 3%. AIN was due to nonsteroidal anti-inflammatory drugs in 27%, antimicrobial agents in 20%, pro- ton pump inhibitors in 5%, and a miscellaneous group of drugs in 18%. In 30% of cases, the culprit drug could not be accurately identified. At baseline, 61% of the patients had normal kidney function, 37% chronic kidney disease (CKD) stage 3, and 2% CKD stage 4. 91% were treated with CS. During the follow-up, 35 patients (17%) achieved CRR, 139 (69%) PR, and 28 (14%) NR. Patients with NR were significantly older (CRR 53622; PR 69612; NR 68612 years, p=0.001), had a lower eGFR at diagnosis (CRR 17616; PR 1368; NR 1169 ml/min/1.73m2, p=0.015), higher degree of proteinuria (CRR 0.960.8; PR 0.860.7; NR 1.962.4 grams/24 hours, p=0.001) and longer delay in the onset of CS therapy (CRR 14616; PR 16623; NR 29648 days, p=0.03). When the interval between drug withdrawal and onset of CS therapy was divided into tertiles, the worst prognosis occurred when the interval was >19 days. Neither mean initial dose of CS, nor the duration of this therapy differed significantly among groups. By Cox regres- sion analysis, the best determinants of persistent renal impairment were proteinuria at diagnosis (HR 2.39; CI95% 1.55-3.67; p<0.0001) and a delay in the onset of CS >19 days (HR 2.17; CI95% 1.21-3.91; p=0.012). CONCLUSIONS: DI-AIN can lead to irreversible renal damage in a significant num- ber of cases. Delayed onset of CS therapy is associated with a worse renal prognosis. Shorter duration of CS therapy might have the same results than prolonged therapy, thereby reducing its side effects. MP191 VARIANTS OF IL1B, IL6 GENE ARE ASSOCIATED WITH THE GENETIC SUSCEPTIBILITY TO IGA NEPHROPATHY IN HAN CHINESE PEOPLE Jiali Wei 1 , Ying Zhang 1 , Maowei Xie 1 , Wenning Li 1 , Daofa Zhang 1 , Xiaohong Yang 1 , Hui Han 1 , Yanni Wang 1 1 Department of Nephrology Hainan General Hospital Haikou China INTRODUCTION AND AIMS: IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide, but etiology and pathogenesis are still poorly understood. Polymorphisms in the cytokine genes may play a role in the etiology and pathogenesis of IgAN. The incidence of difference between different ethnic groups suggested important genetic influences on its pathogenesis. METHODS: We genotyped 10 single nucleotide polymorphisms (SNP) in interleukin (IL)-1B and IL-6 gene using Sequenom Mass-ARRAY technology from 421 IgAN patients and 463 healthy controls of Chinese Han population. We evaluated these SNPs associated with IgAN using the v2 test and genetic model analysis. RESULTS: We identified that the minor alleles of rs16944(“A”), rs1800796(“G”), in IL- 1B, IL-6 were associated with a 1.23-fold and 1.35-fold increased risk of IgAN in allelic model analysis, respectively (P<0.05). In the genetic model analysis, we determined the C/G-G/G genotype of rs1800796 [odds ratio (OR)=1.77, 95% confidence interval (CI)=1.26-2.48, P= 0.0009] and the G/C-G/G genotype [OR=1.56, 95% CI =1.02-2.40, P= 0.041] in the IL-6 gene were associated with increased IgAN risk after adjustment by age and gender, we did not found the IL-1B SNPs were associated with the IgAN risk after adjustment by age and gender. In addition, Haplotype “GGC”, “GAG” and “GAC” in IL-6 were found to be associated with increased IgAN risk (P< 0.05). CONCLUSIONS: This study verified the IL-6,IL-1B genetic variants polymorphisms contributed to IgAN susceptibility in the Han Chinese population. Although we identified SNPs susceptibility, however, replication studies and functional research are required to confirm the genetic contribution in IgAN. MP192 SERUM GDF15 REFLECTS THE ACTIVITY AND PROGRESSION OF IMMUNOGLOBULIN A NEPHROPATHY Ki-Ryang Na 2 , Jin Young Jeong 1 , Chang Hun Song 2 , Hong Jin Bae 2 , Young Rok Ham 2 , Jiwon Lee 3 , Dae eun Choi 2 , Kang Wook Lee 2 1 Department of Medical Science Chungnam National University Daejeon Korea, Republic of, 2 Nephrology, Internal Medicine Chungnam National University Daejeon Korea, Republic of and 3 Pediatrics Chungnam National University Daejeon Korea, Republic of INTRODUCTION AND AIMS: Growth differenciation factor 15 (GDF15) recently reported as a useful prognostic marker in patients with chronic inflammatory disease and heart disease. We evaluated the role of serum GDF15 as an independent marker of renal outcome in immunoglobulin A nephropathy(IgAN). METHODS: 212 patients in a Chungnam National University Hospital glomerulonephritis cohort, who were diagnosed with biopsy-proven IgA nephropathy from March 2010 to June 2014, were included. GDF 15 was analyzed using an enzyme- linked immunosorbent assay. Correlations among initial serum GDF 15, blood urea nitrogen levels, serum creatinine level and estimated glomerular filtration rate (eGFR) and histologic renal inflammation and fibrosis were evaluated. RESULTS: GDF 15 correlated well with initial eGFR (R = À0.649) and mean serum GDF 15 level was correlated with chronic kidney disease (CKD) stage. A GDF 15 level > 496.32 pg/mL showed 90% sensitivity and 72.9% specificity for predicting the need for hemodialysis within 2 years of diagnosis and > 490.4 pg/mL showed 63.64% sensitivity and 65% specificity to predict a decline in eGFR > 30 ml/min in 1 year. In addition, initial serum GDF 15 level was associated with development of interstitial fibrosis/tubular atrophy. CONCLUSIONS: Serum GDF 15 is associated with the renal progression of IgA nephropathy. MP193 MANAGEMENT OF SEVERE LUPUS NEPHRITIS. COMPARISON OF LOW DOSE MYCOPHENOLATE AND INTRAVENOUS PULSE CYCLOPHOSPHAMIDE Ravindra Prabhu 1 , Srinivas Kosuru 1 , Shankar Nagaraju 1 , Dharshan Rangaswamy 1 , Sindhu Kaza 1 , Srikanth Rao 1 , Srinivas Shenoy 1 , Karan Saraf 1 , Mohan B 1 , Ashok Ram 1 , Vasudeva Guddattu 2 1 Nephrology Kasturba Medical College Manipal, Manipal University Manipal India and 2 Statistics Manipal University Manipal India INTRODUCTION AND AIMS: Systemic lupus erythematous (SLE) affects the kidney in about 40 % of cases with severe forms of lupus nephritis (LN) i.e. histopathological classes 3 and 4 being associated with worse outcomes. Combination of steroids with intravenous pulse cyclophosphamide or Mycophenolate mofetil in doses of three grams per day are used as standard therapy with aim to achieve and maintain remission with least adverse effects. We aimed to compare lower dose Mycophenolate mofetil i.e. two grams per day with intravenous pulse cyclophosphamide for remission and adverse effects in LN class 3 and 4. METHODS: We did a prospective observational study of newly diagnosed lupus nephritis class 3 or 4 between 1st August 2012 and 1st June 2016. Baseline demographic data, clinical, laboratory and histopathological features were collected. Patients received either of monthly intravenous pulse cyclophosphamide (Cyc) in escalating doses starting with 750 mg/m 2 up to one gram/m 2 titrated to nadir leukocyte count and kidney function or Mycophenolate mofetil (MMF) two grams/day or equivalent Mycophenolic acid. Both therapies were given as induction followed by maintenance after six months. Minimum follow up of six months was considered for inclusion and patients who switched therapies or received other modalities were excluded. Complete response was defined as return of renal function to normal or baseline and decline of proteinuria to less than 500 mg /day or equivalent urine protein Abstracts Nephrology Dialysis Transplantation iii498 | Abstracts Downloaded from https://academic.oup.com/ndt/article/32/suppl_3/iii498/3853971 by guest on 01 June 2022