The Clinical Significance of Uric Acid and Complement Activation in the Progression of IgA Nephropathy
Tarih
2016Yazar
Sever, Mehmet Sukru
Oztop, Nida
Celik, Dilara
Yazici, Halil
Ozluk, Yasemin
Kilicaslan, Isin
Caliskan, Yasar
Aksoy, Aysun
Ucar, Ayse Serra
Üst veri
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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)] = 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
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