The level of galactose-deficient IgA1 in the sera of patients with IgA nephropathy is associated with disease progression

• Published in: Kidney international Vol. 82; no. 7; pp. 790 - 796
• Main Authors: Zhao, Na, Hou, Ping, Lv, Jicheng, Moldoveanu, Zina, Li, Yifu, Kiryluk, Krzysztof, Gharavi, Ali G., Novak, Jan, Zhang, Hong
• Format: Journal Article
• Language: English
• Published: Basingstoke Elsevier Inc 01.10.2012; Nature Publishing Group; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Biomarkers - blood; Case-Control Studies; Chi-Square Distribution; China; Disease Progression; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Galactose - blood; Galactose - deficiency; galactose-deficient IgA1; Glomerulonephritis; Glomerulonephritis, IGA - blood; Glomerulonephritis, IGA - immunology; Glomerulonephritis, IGA - mortality; Glomerulonephritis, IGA - therapy; Humans; IgA nephropathy; Immunoglobulin A - blood; kidney disease progression; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - immunology; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Prognosis; Proportional Hazards Models; Prospective Studies; Renal Insufficiency - blood; Renal Insufficiency - immunology; Renal Insufficiency - mortality; Renal Insufficiency - therapy; Risk Assessment; Risk Factors; Time Factors; Up-Regulation; Young Adult; China; galactose-deficient IgA1; kidney disease progression; IgA nephropathy; Human; Kidney disease; Immunopathology; Nephrology; Urinary system disease; Prognosis; Disease; IgA1; Urology; Evolution; IgA glomerular nephropathy; Serum; Galactose
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.2012.197

Although high serum levels of galactose-deficient IgA1 (an important biomarker of IgA nephropathy (IgAN)) are found in most patients with IgAN, their relationship to disease severity and progression remains unclear. To help clarify this we prospectively enrolled 275 patients with IgAN and followed them for a median of 47 months (range 12–96 months). Serum galactose–deficient IgA1 was measured at the time of diagnosis using a lectin-based ELISA, and renal survival was modeled using the Cox proportional hazards method. The serum levels of galactose-deficient IgA1 were higher in patients with IgAN compared to those in healthy controls. Importantly, in adjusted analysis, higher levels of galactose-deficient IgA1 were independently associated with a greater risk of deterioration in renal function with a hazard ratio of 1.44 per standard deviation of the natural log–transformed galactose-deficient IgA1 concentration. In reference to the first quartile, the risk of kidney failure increased such that the hazard ratio for the second quartile was 2.47, 3.86 for the third, and 4.76 for the fourth quartile of the galactose-deficient IgA1 concentration. Hence, elevated serum levels of galactose-deficient IgA1 are associated with a poor prognosis in IgAN.