Abstract: SA-PO096

Performance of Immunoglobulin E, Immunoglobulin G, and Combined Both in Predicting Minimal Change Disease before Renal Biopsy

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Tu, Kun-Hua, Chang gung memorial hospital, Taoyuan, Taiwan
  • Lee, Cheng chia, Chang Gung memorial hospital, Taipei, Taiwan
Background

The diagnosis of minimal change disease (MCD) in adults rely mainly on renal biopsy. Procedure of renal biopsy brings not only the diagnostic benefit but also risk of complications. Although advance in image modality of percutaneous renal biopsy, biopsy-related complication still occurs. Bleeding is one of the major complications that may lead to hemodynamic instability and even death in few cases. Thus, development of model to predict MCD for high risk patients unsuitable for renal biopsy is necessary.

Methods

142 patients with nephrotic syndrome who received renal biopsy between October 2007 and April 2011 at one tertiary medical center were enrolled in this study. Demographic, clinical, and pre-biopsy laboratory variables were retrospectively recorded and analyzed.

Results

The overall prevalence of MCD in this study was 26.8%. Age, hemoglobin levels, 24hrs urine protein, IgG, IgE differ significantly between MCD and non-MCD group. Further analyses demonstrated combined above clinical model and this two Ig risk factors (IgG < 450 and IgE > 110) exhibited best discrimination power in predicting the diagnosis of MCD, with the AUROC of 0.91 (95% CI 0.85-0.97, p<0.001).

Conclusion

The current study demonstrated that age, hemoglobin, 24-hours urinary protein are significant predictors of minimal change disease before renal biopsy. Combined above clinical model and this two Ig risk factors provide medical physician simple and valuable clinical markers to diagnose MCD. Further studies are warranted to examine the role of Ig as diagnostic, pathogenic, and prognostic marker in MCD