BACKGROUND: Inflammation and oxidative stress have been incriminated in the pathogenesis of IgA nephropathy (IgAN). The aim of the present study was to assess whether markers reflecting these pathophysiologic processes, namely C-reactive protein (CRP) and advanced oxidation protein products (AOPP), would allow-in conjunction with clinical and histopathologic parameters-to predict disease progression. METHODS: Between 1994 and 1997, 120 adult patients with biopsy-proven IgAN were included in a prospective cohort study, and followed until the end of 2002 or start of dialysis. In every patient, we determined plasma levels of CRP and AOPP. These parameters were included, together with clinical data, in a multivariate Cox proportional hazard regression analysis, with halving of baseline creatinine clearance as the primary renal end point. RESULTS: A total of 51 patients reached the renal end point, including 30 who had to start dialysis. With multivariate analysis, the most potent independent risk factors of poor renal outcome were proteinuria > or =1 g/day [proportional hazard risk (HR) = 23.7, P= 0.0001], hypertension (HR = 8.13, P= 0.008), and AOPP plasma level (HR = 1.09 per 10 micromol/L, P= 0.042), whereas angiotensin II inhibitors were protective (HR = 0.19, P= 0.001). CONCLUSION: Our data support the role of oxidative stress in the pathogenesis of IgAN and suggest that patients with proteinuria > or =1 g/day should be eligible for early implemented antioxidant and/or anti-inflammatory therapeutic strategies, with AOPP plasma level as a surrogate marker to evaluate their effects.
BACKGROUND: Inflammation and oxidative stress have been incriminated in the pathogenesis of IgA nephropathy (IgAN). The aim of the present study was to assess whether markers reflecting these pathophysiologic processes, namely C-reactive protein (CRP) and advanced oxidation protein products (AOPP), would allow-in conjunction with clinical and histopathologic parameters-to predict disease progression. METHODS: Between 1994 and 1997, 120 adult patients with biopsy-proven IgAN were included in a prospective cohort study, and followed until the end of 2002 or start of dialysis. In every patient, we determined plasma levels of CRP and AOPP. These parameters were included, together with clinical data, in a multivariate Cox proportional hazard regression analysis, with halving of baseline creatinine clearance as the primary renal end point. RESULTS: A total of 51 patients reached the renal end point, including 30 who had to start dialysis. With multivariate analysis, the most potent independent risk factors of poor renal outcome were proteinuria > or =1 g/day [proportional hazard risk (HR) = 23.7, P= 0.0001], hypertension (HR = 8.13, P= 0.008), and AOPP plasma level (HR = 1.09 per 10 micromol/L, P= 0.042), whereas angiotensin II inhibitors were protective (HR = 0.19, P= 0.001). CONCLUSION: Our data support the role of oxidative stress in the pathogenesis of IgAN and suggest that patients with proteinuria > or =1 g/day should be eligible for early implemented antioxidant and/or anti-inflammatory therapeutic strategies, with AOPP plasma level as a surrogate marker to evaluate their effects.
Authors: Jun Wang; Min Liang; Jie Xu; Wei Cao; Guo B Wang; Zhan M Zhou; Jian W Tian; Nan Jia; Zhenhai Zhang; Jing Nie; Youhua Liu; Fan F Hou Journal: Lab Invest Date: 2014-07-28 Impact factor: 5.662
Authors: Roberta Camilla; Hitoshi Suzuki; Valentina Daprà; Elisa Loiacono; Licia Peruzzi; Alessandro Amore; Gian Marco Ghiggeri; Gianna Mazzucco; Francesco Scolari; Ali G Gharavi; Gerald B Appel; Stéphan Troyanov; Jan Novak; Bruce A Julian; Rosanna Coppo Journal: Clin J Am Soc Nephrol Date: 2011-07-22 Impact factor: 8.237
Authors: Ho Jun Chin; Hyun Jin Cho; Tae Woo Lee; Ki Young Na; Hyung Jin Yoon; Dong-Wan Chae; Suhnggwon Kim; Un Sil Jeon; Jun-Young Do; Jong-Won Park; Kyung-Woo Yoon; Young-Tai Shin; Kang Wook Lee; Ki-Ryang Na; Dae Ryong Cha; Young Sun Kang Journal: J Korean Med Sci Date: 2009-01-28 Impact factor: 2.153