Evaluation of the Prognostic Value of Inflammatory Biomarkers in Immunoglobulin A Nephropathy

Abstract

Aim: Immunoglobulin A (IgA) nephropathy, the most prevalent primary glomerulonephritis, carries the potential for progression to kidney failure. The research is going on for biomarkers that can be used to predict the prognosis. This study aimed to evaluate the effect of some inflammatory parameters on prognosis in IgA nephropathy. Material And Methods: The study included 53 patients diagnosed with IgA nephropathy. Blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), urinary microprotein/creatinine (Mp/Cr) ratio, white blood cell count (WBC), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) at initial admission, along with eGFR values at subsequent follow-ups (1, 3, and 5 years), were retrospectively analyzed. Poor prognosis was defined as a 50% or greater reduction in eGFR, hemodialysis requirement, kidney transplantation, or exitus. Results: Patients with poor prognosis exhibited higher BUN, creatinine, and Mp/Cr ratio, accompanied by lower eGFR levels. Notably, among the inflammatory biomarkers, only MPV demonstrated a significant difference between the prognosis groups, with lower values observed in the poor prognosis group (p=0.006). ROC analysis revealed significant predictive value for all five parameters (BUN, creatinine, eGFR, urine Mp/Cr and MPV), with MPV showing the highest AUC value (0.78). Conclusion: This study pioneers the evaluation of MPV as a prognostic marker in IgA nephropathy. Pending confirmation through subsequent investigations, MPV holds promise as a valuable prognostic indicator for IgA nephropathy.