title: The Clinical Significance of Uric Acid and Complement Activation in the Progression of IgA Nephropathy.
abstract: OBJECTIVE
  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 follow-up 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 1.023-1.621, 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 (β=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.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Caliskan
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozluk
authors.forename: Dilara
authors.initials: D
authors.lastname: Celik
authors.forename: Nida
authors.initials: N
authors.lastname: Oztop
authors.forename: Aysun
authors.initials: A
authors.lastname: Aksoy
authors.forename: Ayse Serra
authors.initials: AS
authors.lastname: Ucar
authors.forename: Halil
authors.initials: H
authors.lastname: Yazici
authors.forename: Isin
authors.initials: I
authors.lastname: Kilicaslan
authors.forename: Mehmet Sukru
authors.initials: MS
authors.lastname: Sever
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003167:Complement Activation / Q000502:physiology; D003176:Complement C3; D018450:Disease Progression; D005260:Female; D005922:Glomerulonephritis, IGA / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D033461:Hyperuricemia / Q000097:blood* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003176:Complement C3; D014527:Uric Acid