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. , ...More

Kidney & blood pressure research, vol.41, no.2, pp.148-57, 2016 (Journal Indexed in SCI Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 41 Issue: 2
  • Publication Date: 2016
  • Doi Number: 10.1159/000443415
  • Title of Journal : Kidney & blood pressure research
  • Page Numbers: pp.148-57
  • Keywords: Biomarkers, Complement, End stage renal disease, IgA Nephropathy, Uric acid, CHRONIC KIDNEY-DISEASE, GLOMERULAR DEPOSITION, OXFORD CLASSIFICATION, PREDICT, FEATURES, PATHWAY, SYSTEM, STAGE

Abstract

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