ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO1007

High Serum IgA/C3 Ratio Better Predicts a Diagnosis of IgA Nephropathy Among Primary Glomerular Nephropathy with Proteinuria ≤1 g/d: An Observational Cross-Sectional Study

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Author

  • Zhang, Jun, Department of Nephrology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Background

Serum immunoglobulin A (IgA)/C3 ratio is considered to be an effective predictor of IgA nephropathy (IgAN).This study aims to explore the diagnostic value of serum IgA/C3 ratio in IgAN among primary glomerular nephropathy in China.

Methods

We recruited 1095 biopsy-diagnosed primary glomerular nephropathy patients including 757 IgAN patients and 338 Non-IgAN patients. Social demography, serum immunological indexes and other clinical examinations were measured. IgAN cases were propensity scored matched (PSM) to Non-IgAN cases on the logit of the propensity score using nearest neighbor matching in a 1:1 fashion with a caliper of 0.02 with no replacements, according to age, gender, BMI, proteinuria and eGFR.

Results

We found that, both in the full cohort and PSM cohort, serum IgA/C3 ratio in IgAN group was significantly higher than those in Non-IgAN group. The same results were also obtained at different levels of proteinuria and renal function stratification. In the PSM cohort, there was no difference in IgA/C3 ratio in patients with IgAN between different proteinuria groups and different CKD groups. The area under the ROC curve (AUROC) for IgA/C3 ratio in distinguishing IgAN among primary glomerular disease was 0.767 in the full cohort and 0.734 in the PSM cohort. The highest AUROC of IgA/C3 ratio was in the proteinuria≤1 g/d group (0.801 in the full cohort, and 0.803 in the PSM cohort); however, there was no difference between all the CKD groups. Meanwhile, the diagnose accordance rate of diagnostic of IgAN among all those patients with IgA/C3 ratio > 3.5304 was as high as 92.02% in the full cohort. Multivariate logistic regression analysis showed, IgAN was independently correlated with age, albumin, CKD 2 stage and CKD 3-5 stage (versus CKD 1 stage) and IgA/C3 ratio.

Conclusion

The present study provided clear evidence that IgA/C3 ratio is an effective predictor of IgA diagnosis, especially in patients with proteinuria ≤ 1g/d. In order to study the effectiveness of this biomarker and to determine a standardized cut-off value, large-scale studies are necessary.