Serum immunoglobulin A/C3 ratio predicts progression of immunoglobulin A nephropathy.

Abstract

AIM:

The serum immunoglobulin A (IgA)/C3 ratio has been shown to be a good predictor of histological lesions and prognosis for patients with IgA nephropathy (IgAN) in Japanese. But its validity in the Chinese population is unclear. We sought to explore the long-term outcomes of IgAN, its clinical and histopathological predictors in Chinese patients. In particular, the role of serum IgA/C3 ratio in the course of IgAN was addressed.

METHODS:

A total of 217 biopsy-diagnosed IgAN patients were recruited into this prospective cohort with a mean follow-up of 36 months (25-75th percentile, 27-48). Sociodemographics, serum IgA/C3 level, other clinical examinations and Lee's histological grade were measured. The patients with a decline of estimated glomerular filtration rate (eGFR) > 50% or developing end-stage renal disease (ESRD) were defined as progression.

RESULTS:

A total of 21 patients was found to progress (9.7%). In multivariate analysis, renal end point of IgAN was significantly predicted by proteinuria ≥1 g/day (relative risk (RR) = 2.65, 95% confidence interval (CI) 1.01-7.68), hypertension (RR = 3.15, 95% CI 1.07-9.29), higher Lee's histological grade (RR = 4.67, 95% CI 1.43-15.25) and serum IgA/C3 ratio ≥ 3.32 (RR = 4.31, 95% CI 1.33-13.96).

CONCLUSION:

A proportion of patients with IgAN developed end stage renal disease in a Chinese group. In addition to some traditional risk factors, we also confirmed that IgA/C3 ratio is a useful predictor of poor outcomes of IgAN in Chinese patients.

• Authors: Jun Zhang, Cheng Wang, Ying Tang, Hui Peng, Zeng-Chun Ye, Cui-Cui Li, Tan-Qi Lou
• Journal: Nephrology (Carlton, Vic.) (Nephrology (Carlton)) Vol. 18 Issue 2 Pg. 125-31 (Feb 2013) ISSN: 1440-1797 [Electronic] Australia
• PMID: 23134230 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.

Chemical References

• Biomarkers
• Complement C3
• Immunoglobulin A

Topics

• Adult
• Asian People
• Biomarkers (blood)
• Biopsy
• Chi-Square Distribution
• China (epidemiology)
• Complement C3 (analysis)
• Disease Progression
• Female
• Glomerular Filtration Rate
• Glomerulonephritis, IGA (blood, ethnology, immunology, pathology, physiopathology)
• Humans
• Immunoglobulin A (blood)
• Kaplan-Meier Estimate
• Kidney (pathology, physiopathology)
• Kidney Failure, Chronic (ethnology, immunology)
• Male
• Multivariate Analysis
• Predictive Value of Tests
• Prognosis
• Proportional Hazards Models
• Prospective Studies
• Proteinuria (ethnology, immunology)
• Risk Factors
• Time Factors
• Young Adult