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2015 ; 10
(7
): e0132826
Nephropedia Template TP
gab.com Text
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Circulating Tumor Necrosis Factor ? Receptors Predict the Outcomes of Human IgA
Nephropathy: A Prospective Cohort Study
#MMPMID26177311
Oh YJ
; An JN
; Kim CT
; Yang SH
; Lee H
; Kim DK
; Joo KW
; Paik JH
; Kang SW
; Park JT
; Lim CS
; Kim YS
; Lee JP
PLoS One
2015[]; 10
(7
): e0132826
PMID26177311
show ga
The circulating tumor necrosis factor receptors (TNFRs) could predict the
long-term renal outcome in diabetes, but the role of circulating TNFRs in other
chronic kidney disease has not been reported. Here, we investigated the
correlation between circulating TNFRs and renal histologic findings on kidney
biopsy in IgA nephropathy (IgAN) and assessed the notion that the circulating
TNFRs could predict the clinical outcome. 347 consecutive biopsy-proven IgAN
patients between 2006 and 2012 were prospectively enrolled. Concentrations of
circulating TNFRs were measured using serum samples stored at the time of biopsy.
The primary clinical endpoint was the decline of estimated glomerular filtration
rate (eGFR; ? 30% decline compared to baseline). Mean eGFR decreased and
proteinuria worsened proportionally as circulating TNFR1 and TNFR2 increased (P <
0.001). Tubulointerstitial lesions such as interstitial fibrosis and tubular
atrophy were significantly more severe as concentrations of circulating TNFRs
increased, regardless of eGFR levels. The risks of reaching the primary endpoint
were significantly higher in the highest quartile of TNFRs compared with other
quartiles by the Cox proportional hazards model (TNFR1; hazard ratio 7.48, P <
0.001, TNFR2; hazard ratio 2.51, P = 0.021). In stratified analysis according to
initial renal function classified by the eGFR levels of 60 mL/min/1.73 m2, TNFR1
and TNFR2 were significant predictors of renal progression in both subgroups. In
conclusion, circulating TNFRs reflect the histology and clinical severity of
IgAN. Moreover, elevated concentrations of circulating TNFRs at baseline are
early biomarkers for subsequent renal progression in IgAN patients.