Author:
Liu Xiao,Gong Shaomin,Ning Yichun,Li Yang,Zhou Huili,He Luna,Lin Lin,Jin Shi,Shen Ziyan,Zhu Bowen,Li Fang,Li Jie,Tan Xiao,Jiao Xiaoyan,Shi Yiqin,Ding Xiaoqiang
Abstract
Abstract
Background
Tubulointerstitial lesions play a pivotal role in the progression of IgA nephropathy (IgAN). Elevated N-acetyl-beta-D-glucosaminidase (NAG) in urine is released from damaged proximal tubular epithelial cells (PTEC) and may serve as a biomarker of renal progression in diseases with tubulointerstitial involvement.
Methods
We evaluated the predictive value of urinary NAG (uNAG) for disease progression in 213 biopsy-proven primary IgAN patients from January 2018 to December 2019 at Zhongshan Hospital, Fudan University. We compared the results with those of serum cystatin C (sCysC).
Results
Increased uNAG and sCysC levels were associated with worse clinical and histological manifestations. Only uNAG level was independently associated with remission status after adjustment. Patients with high uNAG levels (> 22.32 U/g Cr) had a 4.32-fold greater risk of disease progression. The combination of baseline uNAG and clinical data may achieve satisfactory risk prediction in IgAN patients with relatively preserved renal function (eGFR ≥ 60 ml/min/1.73 m2, area under the curve [AUC] 0.760).
Conclusion
Our results suggest that uNAG is a promising biomarker for predicting IgAN remission status.
Funder
National Natural Science Foundation of China and the Science
Research Fund for the development of nephropathy medicine
Shanghai Key Laboratory of Kidney and Blood Purification
Shanghai Medical Centre of Kidney
Shanghai Municipal Key Clinical Specialty
Publisher
Springer Science and Business Media LLC
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