Berthoux et al. [21] recently reported that Gd-IgA1 and IgA/IgG-IC may have a predictive value for outcome of renal death in IgAN. We examined these biomarkers from a perspective that is different from their study. The present study examined whether serum levels of these noninvasive biomarkers
can be a potential index for the disease activity of IgAN equivalent to urinalysis, in patients with complete or partial clinical remission after steroid pulse therapy in combination with tonsillectomy (TSP) whose clinical data and serum were selleck obtained 3–5 years after TSP. Materials and methods Patients and Androgen Receptor Antagonists treatment IgAN diagnosis requires renal biopsy with IgA as the dominant or co-dominant Igs in a typical mesangial distribution in the absence of clinical and laboratory evidence of systemic disease. We enrolled IgAN patients showing complete/partial clinical remission after TSP from 1999−2001 in Sendai Shakaihoken Hospital and who could be followed up and see more whose serum could be obtained serially for 3–5 years after TSP. Clinical remission was defined
as negative proteinuria and hematuria as assessed using a dipstick test and/or a urinary erythrocyte count of <5 cells per high-power field during 3 consecutive visits. We defined patients with complete remission as those who showed no further urinary abnormalities throughout the observation period after urinary abnormalities disappeared. Patients who exhibited a relapse of proteinuria and/or hematuria after remission were excluded from the complete remission group, but were included in a partial remission group. The steroid pulse therapy included 0.5 g methylprednisolone per day for 3
consecutive days, 3 times a week, for at least 1 week after tonsillectomy. Furthermore, 0.5 mg/body weight (kg) prednisolone was administrated once every 2 days for 6–12 months with a gradual tapering of the dose within 1 year [22]. Patients who had received a kidney transplant or who required dialysis were excluded from this study. This study was approved by the ethics committee of the Sendai Shakaihoken Hospital at Miyagi, Japan, and all patients provided written informed consent. Clinical, laboratory BCKDHA and pathological data We collected the baseline clinical data immediately before TSP, while qualitative hematuria and proteinuria data and serum were collected at a minimum of three time points, i.e., immediately before, 1 year after, and 3–5 years after TSP. Baseline clinical data (age, sex, duration from onset to tonsillectomy, systolic blood pressure, total protein, albumin, blood urea nitrogen, serum creatinine, creatine clearance rate [CCr], quantitative proteinuria, amount of proteinuria, and quantitative hematuria) and histological findings were collected from hospital medical records. CCr was calculated based on the mean 24-h urine collection and adjusted for body surface area.