Caliskan/Ozluk/Celik/Oztop/Aksoy/Ucar/Yazici/Kilicaslan/Sever: Uric Acid and Complement Activation in IgA Nephropathy
Background/Aims: The aim of this study is to investigate the utility of clinical [age, gender, mean arterial pressure (MAP) and laboratory parameters [eGFR, hemoglobin (Hgb) serum levels of creatinine, uric acid, albumin, proteinuria, hematuria] and also histopathological lesions (Oxford classification parameters, crescents, intensity and pattern of staining for C3, C1Q, IgA, IgG, IgM) as progression markers in patients with IgA Nephropathy (IgAN) Methods: A total of 111 IgAN patients with a follow up period >1 year or who reached kidney failure [GFR category G5 chronic kidney disease (CKD) <1 year were investigated. Primary endpoint was the development of kidney failure or eGFR decline =50% from the baseline. Kaplan Meier and Cox proportional hazards analyses were performed. Results: Mean followup period was 33+ 29 months. Thirty seven (33.3% patients progressed to kidney failure and 4 (3.6% patients developed eGFR decline =50% from the baseline after a median of 23 and 65 months, respectively. In multivariate Cox regression analysis, baseline levels of Hgb (HR:0.782, 95% CI 0.559 0.973, p=0.037) serum uric acid (HR:1.293, 95% CI 1.0231.621, p=0.046) eGFR (HR:0.966, 95% CI 0.947 0.984, p=0.004) and intensity of C3 staining (HR:1.550, 95% CI 1.198 1.976, p=0.049) predicted primary endpoint. Serum uric acid level was associated independently with T score (b=0.303, p=0.005) in patients with eGFR>30 ml/ min/m2. Conclusions: Hyperuricemia and the deposition of C3 are independent risk factors for IgAN progression.