Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy.
After activation, the complement system is involved in the pathogenesis of Immunoglobulin A nephropathy (IgAN). Complement factor H (CFH) is a crucial inhibitory factor of the alternative pathway of the complement system. The study investigated the effects of urinary CFH levels on IgAN progression.A...
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doaj-8435b6114bff42beb8fd4925cf32f5882020-11-25T01:21:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01106e012681210.1371/journal.pone.0126812Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy.Maojing LiuYuqing ChenJingjing ZhouYing LiuFengmei WangSufang ShiYanfeng ZhaoSuxia WangLijun LiuJicheng LvHong ZhangMinghui ZhaoAfter activation, the complement system is involved in the pathogenesis of Immunoglobulin A nephropathy (IgAN). Complement factor H (CFH) is a crucial inhibitory factor of the alternative pathway of the complement system. The study investigated the effects of urinary CFH levels on IgAN progression.A total of 351 patients with IgAN participated in this study. They were followed up for an average of 51.8 ± 26.6 months. Renal outcome was defined as a composite endpoint, that included instances of end-stage renal disease (ESRD), ≥ 50% decline in estimated glomerular filtration rate (eGFR) or doubling of plasma creatinine levels. Urinary CFH levels were measured by enzyme-linked immunosorbent assay and calculated as the ratio of urinary CFH over creatinine (uCFH/uCr).In the whole cohort, uCFH/uCr values were associated with disease progression either as continuous [log(uCFH/uCr)] or categorical traits (dichotomous and quartile variables) after adjusting for eGFR, proteinuria, mean arterial blood pressure, histological grading and immunosuppressive therapy in the Cox proportional hazard model. Kaplan-Meier analysis showed that higher uCFH/uCr values at baseline predicted worse renal outcome during follow-up (log-rank, P < 0.001). Receiver operating characteristic curve (ROC) analysis showed that log(uCFH/uCr) had predictive value for renal outcome (area under curve [AUC] = 0.745), and the AUC increased to 0.805 after being incorporated into baseline eGFR and proteinuria. In subgroup analysis with eGFR ≥ 60 mL/min/1.73 m2, log(uCFH/uCr) had better predictive value (AUC = 0.724, P = 0.002) for renal outcome compared to eGFR (AUC = 0.582, P = 0.259) and proteinuria (AUC = 0.615, P = 0.114).Urinary CFH levels are associated with renal function decline and increased urinary CFH levels are a risk factor for progression of IgA nephropathy.http://europepmc.org/articles/PMC4452759?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maojing Liu Yuqing Chen Jingjing Zhou Ying Liu Fengmei Wang Sufang Shi Yanfeng Zhao Suxia Wang Lijun Liu Jicheng Lv Hong Zhang Minghui Zhao |
spellingShingle |
Maojing Liu Yuqing Chen Jingjing Zhou Ying Liu Fengmei Wang Sufang Shi Yanfeng Zhao Suxia Wang Lijun Liu Jicheng Lv Hong Zhang Minghui Zhao Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. PLoS ONE |
author_facet |
Maojing Liu Yuqing Chen Jingjing Zhou Ying Liu Fengmei Wang Sufang Shi Yanfeng Zhao Suxia Wang Lijun Liu Jicheng Lv Hong Zhang Minghui Zhao |
author_sort |
Maojing Liu |
title |
Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. |
title_short |
Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. |
title_full |
Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. |
title_fullStr |
Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. |
title_full_unstemmed |
Implication of urinary complement factor H in the progression of immunoglobulin A nephropathy. |
title_sort |
implication of urinary complement factor h in the progression of immunoglobulin a nephropathy. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2015-01-01 |
description |
After activation, the complement system is involved in the pathogenesis of Immunoglobulin A nephropathy (IgAN). Complement factor H (CFH) is a crucial inhibitory factor of the alternative pathway of the complement system. The study investigated the effects of urinary CFH levels on IgAN progression.A total of 351 patients with IgAN participated in this study. They were followed up for an average of 51.8 ± 26.6 months. Renal outcome was defined as a composite endpoint, that included instances of end-stage renal disease (ESRD), ≥ 50% decline in estimated glomerular filtration rate (eGFR) or doubling of plasma creatinine levels. Urinary CFH levels were measured by enzyme-linked immunosorbent assay and calculated as the ratio of urinary CFH over creatinine (uCFH/uCr).In the whole cohort, uCFH/uCr values were associated with disease progression either as continuous [log(uCFH/uCr)] or categorical traits (dichotomous and quartile variables) after adjusting for eGFR, proteinuria, mean arterial blood pressure, histological grading and immunosuppressive therapy in the Cox proportional hazard model. Kaplan-Meier analysis showed that higher uCFH/uCr values at baseline predicted worse renal outcome during follow-up (log-rank, P < 0.001). Receiver operating characteristic curve (ROC) analysis showed that log(uCFH/uCr) had predictive value for renal outcome (area under curve [AUC] = 0.745), and the AUC increased to 0.805 after being incorporated into baseline eGFR and proteinuria. In subgroup analysis with eGFR ≥ 60 mL/min/1.73 m2, log(uCFH/uCr) had better predictive value (AUC = 0.724, P = 0.002) for renal outcome compared to eGFR (AUC = 0.582, P = 0.259) and proteinuria (AUC = 0.615, P = 0.114).Urinary CFH levels are associated with renal function decline and increased urinary CFH levels are a risk factor for progression of IgA nephropathy. |
url |
http://europepmc.org/articles/PMC4452759?pdf=render |
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