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Abstract: PO1592

Urinary Transferrin and IgG Are Significant and Early Markers of Tubulointerstitial Lesions in Patients with IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Saganova, Elena, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Galkina, Olga, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
  • Sipovskii, Vasiliy, Pervyj Sankt-Peterburgskij gosudarstvennyj medicinskij universitet imeni akademika I P Pavlova, Sankt Peterburg, Sankt Peterburg, Russian Federation
Background

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis and is a frequent cause of end-stage renal disease. There is a pressing need to identify suitable noninvasive biomarkers in IgAN, to aid with diagnosis, treatment decisions, prediction of the histological lesions and disease progression. Our aim was to assess diagnostic value of urinary transferrin and IgG excretions in prediction of morphological lesions in patients with IgAN.

Methods

37 patients [19 female, age Me 33 (25; 48) years] with biopsy proven IgAN and without acute kidney injury, infectious diseases, severe heart failure, respiratory insufficiency, cancer were included in the study. 24-hour urinary excretions of transferrin (uTr), IgG (uIgG) were measured by immunoturbidimetric method. Tubulointerstitial fibrosis (TIF), tubular atrophy (TA) were assessed semi-quantitatively (0-lesions absent; 1-mild focal tubular and interstitial lesions; 2-moderate tubular and interstitial lesions; 3-diffuse tubular and interstitial lesions). All patients consistently were separated into two groups according to the degree of each morphological lesion (TIF or TA): “mild” (TIF or TA grade 0 or 1) and “severe” (TIF/TA grade 2-3).

Results

uTr, uIgG positively correlated (p<0,05) with TIF (r=0,38, r=0,43) and TA (r=0,38, r=0,45), respectively. We did not find correlations between uTr, uIgG and glomerulosclerosis. Using ROC-analysis all patients were separated in two groups using uTr or uIgG according to the degree of morphological lesions (“mild” or “severe) (Figure 1). We also found that all cut-off values of uTr, uIgG corresponded to the level of urinary protein excretion not more than 1,25 g/24hour.

Conclusion

Our data shows that uTr and uIgG can be used as markers of early tubulointerstitial lesions in patients with IgA nephropathy with mild protein excretion (<1,25 g/24hour).

Figure 1. ROC curves of urinary transferrin and IgG excretions in prediction: A – TIF; B –TA.

Funding

  • Government Support – Non-U.S.