A novel differential diagnostic model based on multiple biological parameters for immunoglobulin A nephropathy.
BACKGROUND
Immunoglobulin A nephropathy (IgAN) is the most common form of glomerulonephritis in China. An accurate diagnosis of IgAN is dependent on renal biopsies, and there is lack of non-invasive and practical classification methods for discriminating IgAN from other primary kidney diseases. The objective of this study was to develop a classification model for the auxiliary diagnosis of IgAN using multiparameter analysis with various biological parameters.


METHODS
To establish an optimal classification model, 121 cases (58 IgAN vs. 63 non-IgAN) were recruited and statistically analyzed. The model was then validated in another 180 cases.


RESULTS
Of the 57 biological parameters, there were 16 parameters that were significantly different (P < 0.05) between IgAN and non-IgAN. The combination of fibrinogen, serum immunoglobulin A level, and manifestation was found to be significant in predicting IgAN. The validation accuracies of the logistic regression and discriminant analysis models were 77.5 and 77.0%, respectively at a predictive probability cut-off of 0.5, and 81.1 and 79.9%, respectively, at a predictive probability cut-off of 0.40. When the predicted probability of the equation containing the combination of fibrinogen, serum IgA level, and manifestation was more than 0.59, a patient had at least an 85.0% probability of having IgAN. When the predicted probability was lower than 0.26, a patient had at least an 88.5% probability of having non-IgAN. The results of the net reclassification improvement certificated serum Immunoglobulin A and fibrinogen had classification power for discriminating IgAN from non-IgAN.


CONCLUSIONS
These models possess potential clinical applications in distinguishing IgAN from other primary kidney diseases.
Department of Clinical Biochemistry, State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, Beijing 100853, China.
Jing
J
Gao
Yong
Y
Wang
Zhennan
Z
Dong
Zhangming
Z
Yan
Xingwang
X
Jia
Yaping
Y
Tian
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; D007070:Immunoglobulin A; D005340:Fibrinogen