title: Relationship between serum IgA/C3 ratio and severity of histological lesions using the Oxford classification in children with IgA nephropathy.
abstract: BACKGROUND
  The aim of this study was to evaluate the usefulness of serum immunoglobulin A/complement factor 3 (IgA/C3) ratio for predicting histological severity of kidney lesions in children with IgA nephropathy (IgAN) based on World Health Organization (WHO) and the Oxford classification (OC).
  
  
  METHODS
  We studied 89 children with IgAN with a mean age of 11.38 ± 4.1 years (range 2-18 years). Based on available medical records, we retrospectively evaluated clinical data, IgA/C3 ratio, and kidney biopsy findings using the five-grade WHO classification and the OC The mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental sclerosis (S), tubular atrophy/interstitial fibrosis (T) (MEST) score (absent = 0, present = 1) calculated as the sum of M+E+S+T ranging from 0 to 4.
  
  
  RESULTS
  Mean IgA/C3 ratio values were significantly higher (P < 0.05) in patients with M1, S1, and T1 compared with M0, S0, and T0, respectively (P < 0.05); there were no differences in the WHO classification. We found a significant positive correlation between the IgA/C3 ratio and proteinuria (r = 0.24) and determined optimal cutoff values of the IgA/C3 ratio, with a corresponding confidence interval for specific MEST scores.
  
  
  CONCLUSIONS
  The IgA/C3 ratio in children with IgAN may be a useful marker of the severity of lesions found in kidney biopsy as evaluated using the OC.
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland, wasiaczki@wp.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Mizerska-Wasiak
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Małdyk
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Rybi-Szumińska
authors.forename: Anna
authors.initials: A
authors.lastname: Wasilewska
authors.forename: Monika
authors.initials: M
authors.lastname: Miklaszewska
authors.forename: Jacek
authors.initials: J
authors.lastname: Pietrzyk
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Firszt-Adamczyk
authors.forename: Roman
authors.initials: R
authors.lastname: Stankiewicz
authors.forename: Beata
authors.initials: B
authors.lastname: Bieniaś
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Zajączkowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Gadomska-Prokop
authors.forename: Ryszard
authors.initials: R
authors.lastname: Grenda
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Pukajło-Marczyk
authors.forename: Danuta
authors.initials: D
authors.lastname: Zwolińska
authors.forename: Maria
authors.initials: M
authors.lastname: Szczepańska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Turczyn
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001284:Atrophy; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000032:analysis*; D005260:Female; D005355:Fibrosis; D005920:Glomerular Mesangium / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000097:blood / Q000145:classification / Q000473:pathology*; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007223:Infant; D007668:Kidney / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000378:metabolism; D012307:Risk Factors; D014556:Urine / Q000166:cytology
chemical_list: D015415:Biomarkers; D003176:Complement C3; D007070:Immunoglobulin A