The Clinical Significance of Uric Acid and Complement Activation in the Progression of IgA Nephropathy.

Caliskan Y., Ozluk Y., Celik D., Oztop N., Aksoy A., Ucar A. S., ...Daha Fazla

Kidney & blood pressure research, cilt.41, sa.2, ss.148-57, 2016 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 41 Sayı: 2
  • Basım Tarihi: 2016
  • Doi Numarası: 10.1159/000443415
  • Dergi Adı: Kidney & blood pressure research
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.148-57
  • Anahtar Kelimeler: Biomarkers, Complement, End stage renal disease, IgA Nephropathy, Uric acid, CHRONIC KIDNEY-DISEASE, GLOMERULAR DEPOSITION, OXFORD CLASSIFICATION, PREDICT, FEATURES, PATHWAY, SYSTEM, STAGE
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background/Aims: The aim of this study is to investigate the utility of clinical [age, gender, mean arterial pressure (MAP)] and laboratory parameters [eGFR, hemoglobin (Hgb), serum levels of creatinine, uric acid, albumin, proteinuria, hematuria] and also histopathological lesions (Oxford classification parameters, crescents, intensity and pattern of staining for C3, C1Q, IgA, IgG, IgM) as progression markers in patients with IgA Nephropathy (IgAN). Methods: A total of 111 IgAN patients with a follow-up period >1 year or who reached kidney failure [GFR category G5 chronic kidney disease (CKD)] <1 year were investigated. Primary endpoint was the development of kidney failure or eGFR decline >= 50% from the baseline. Kaplan-Meier and Cox proportional hazards analyses were performed. Results: Mean followup period was 33+/-29 months. Thirty-seven (33.3%) patients progressed to kidney failure and 4 (3.6%) patients developed eGFR decline >= 50% from the baseline after a median of 23 and 65 months, respectively. In multivariate Cox regression analysis, baseline levels of Hgb (HR: 0.782, 95% CI 0.559-0.973, p=0.037), serum uric acid (HR: 1.293, 95% CI 1.0231.621, p=0.046), eGFR (HR: 0.966, 95% CI 0.947-0.984, p=0.004) and intensity of C3 staining (HR: 1.550, 95% CI 1.198-1.976, p=0.049) predicted primary endpoint. Serum uric acid level was associated independently with T score (beta=0.303, p=0.005) in patients with eGFR>30 ml/min/m(2). Conclusions: Hyperuricemia and the deposition of C3 are independent risk factors for IgAN progression. (C) 2016 The Author(s) Published by S. Karger AG, Basel