Serum IgA/C3 Ratio May Predict Diagnosis and Prognostic Grading in Patients with IgA Nephropathy

Ishiguro, Chizuru; Yaguchi, Yutaka; Funabïki, Kazuhiko; Horikoshi, Satoshi; Shirato, Isao; Tomino, Yasuhiko

doi:10.1159/000065043

Cited by 31 publications

(38 citation statements)

References 5 publications

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“…They also indicated that applying the ratio of serum IgA to C3 to diagnosing IgAN improves both sensitivity and specificity. Ishiguro et al (8) reported that the serum IgA/C3 ratio appears to increase according to the prognostic grading of IgAN based on their recalculated serum IgA and C3 levels, but differences among the graded groups were not statistically significant. Our results show that the serum IgA/C3 ratio not only distinguishes between IgAN and other primary glomerular diseases, but it also reflects the pathological severity of IgAN.…”

Section: Discussionmentioning

confidence: 98%

“…Using this standard, Tomino et al (7) found that serum IgA and C3 might predict IgAN in patients before renal biopsy and recommended that a serum IgA level of over 315 mg/dl should be the diagnostic standard for IgAN. Moreover, the serum IgA/C3 ratio might predict prognostic grading in patients with IgAN (8). Here, we evaluated the value of the serum IgA/C3 ratio in assessing the prognosis of patients and the histological severity of IgAN.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Serum IgA/C3 Ratio and Progression of IgA Nephropathy

et al. 2004

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Objective The serum IgA/C3 ratio might be considered to serve as a diagnostic marker for patients with IgA nephropathy (IgAN), but its value as a marker of the severity of histological lesions or prognosis is unknown.Methods We studied the serum IgA/C3 ratio, using standardized reference material, in 86 patients with IgAN and in 32 with non-IgAN. The patients with IgAN were divided according to the severity of histological lesions (mild IgAN, n=29 and severe IgAN, n=57) based on Japanese clinical guidelines.Results The serum IgA level was significantly higher, while its C3 level was lower in patients with severe IgAN compared to those with non-IgAN. However, these levels were not different between patients with mild IgAN and non-IgAN. In contrast, the serum IgA/C3 ratio obviously differed among the three groups (2.47±0.96 vs. 3.63±1.44 vs. 4.72±1.86; p<0.01, ANOVA). Kaplan-Meier analysis of the patients with IgAN classified according to the mean serum IgA/C3 ratio revealed that the group with high serum IgA/C3 (4.5 and above) had a significantly poorer renal outcome (p<0.05, log-rank test), since the cumulative renal survival rate at 5 years was 84.4% vs. 100%. The ratio (%) of patients with severe IgAN in whom hematuria disappeared, was significantly higher in the low, than in the high serum IgA/C3 group (41.9% vs. 15.4%; p<0.05, t-test).Conclusion The serum IgA/C3 ratio appears to reflect the histological severity of IgAN and could serve as a marker of the progression of IgAN.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Relationship between Serum IgA/C3 Ratio and Progression of IgA Nephropathy

et al. 2004

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“…The levels of serum IgA and C3 were measured by the automated Dade Behring Nephelometer II (Dade Behring Marburg GmbH, Marburg, Germany) using a new, widely accepted reference material (IFCC/CRM 470) before and after therapy [8, 9, 11], and the ratio of serum IgA to C3 (serum IgA/C3 ratio) was then calculated.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, there have been some reports demonstrating that the serum IgA/C3 ratio might predict prognostic grading in adults with IgA nephropathy [8, 9]. The aim of this study was to evaluate whether the serum IgA/C3 ratio can be a useful marker of disease activity, and correlates with the clinical outcome and the severity of renal pathology in children with severe HSN.…”

Section: Introductionmentioning

confidence: 99%

Serum IgA/C3 Ratio May Be a Useful Marker of Disease Activity in Severe Henoch-Schönlein Nephritis

et al. 2005

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Background/Aims: This study was designed to investigate whether the serum IgA/C3 ratio can be a serologic marker of disease activity in children with severe Henoch-Schönlein nephritis (HSN). Methods: Twelve HSN patients who were treated with steroids and cyclosporine were examined. The levels of serum IgA and C3 were measured using an international reference preparation (IFCC/CRM470) and a renal biopsy was performed in all patients before and after therapy. After therapy, patients were divided into 3 groups: complete remission (n = 6, group I), mild urinary abnormalities (n = 3, group II), and active renal disease (n = 3, group III). Results: The serum IgA/C3 ratio decreased significantly in groups I and II after therapy (2.62 ± 0.82 vs. 2.02 ± 0.52, p = 0.02), whereas the ratio in group III increased, although it was not statistically significant (2.13 ± 0.93 vs. 4.67 ± 1.71, p = 0.25). A follow-up renal biopsy revealed that the activity index was reduced in groups I and II (7.0 ± 2.4 vs. 3.6 ± 1.6, p = 0.016), and not changed in group III (7.3 ± 2.1 vs. 9.3 ± 2.5, p = 0.25). The activity index at a follow-up renal biopsy correlated positively with the changes of the serum IgA/C3 ratio: posttherapy activity index = 1.20 × ΔIgA/C3 + 4.78 (r = 0.635, p = 0.027); where ΔIgA/C3 is posttherapy IgA/C3 – pretherapy IgA/C3. Conclusion: These findings suggest that the serum IgA/C3 ratio may be a useful marker to predict disease activity and histologic severity in HSN.

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“…Ishiguro et al (4) reported that the levels of serum IgA and C3 in patients with IgA nephropathy and other glomerular diseases were adjusted by a special formula to those using international standard serum (IFCC/CRM470). The results showed the highest serum IgA/C3 ratio in patients with IgA nephropathy.…”

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confidence: 99%

Serum IgA/C3 Ratio May Predict Diagnosis and Prognostic Grading in Patients with IgA Nephropathy

Cited by 31 publications

References 5 publications

Relationship between Serum IgA/C3 Ratio and Progression of IgA Nephropathy

Relationship between Serum IgA/C3 Ratio and Progression of IgA Nephropathy

Serum IgA/C3 Ratio May Be a Useful Marker of Disease Activity in Severe Henoch-Schönlein Nephritis

Relationship between the Serum IgA/C3 Ratio and the Progression of IgA Nephropathy

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