A non-invasive diagnostic model of immunoglobulin A nephropathy and serological markers for evaluating disease severity  

作　　者：Qiu-Xia Han Yong Wang Han-Yu Zhu Dong Zhang Jing Gao Zhang-Suo Liu Guang-Yan Cai Xiang-Mei Chen 

机构地区：[1]Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology in Zhengzhou University, Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, Henan 450052, China [2]Department of Nephrology, Chinese People's Liberation Army General Hospital, Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing 100853, China [3]Department of Clinical Biochemistry, Chinese People's Liberation Army General Hospital, Beijing 100853, China

出　　处：《Chinese Medical Journal》2019年第6期647-652,共6页中华医学杂志（英文版）

基　　金：grants from the National Key R&D Program of China (No. 2016YFC1305500);the National Natural Science Foundation of China (Nos. 61471399, 61671479, and 81670663);the National Key Research and Development Program (No. 2016YFC1305404);and the Joint Funds of National Natural Science Foundation of China and Henan Province (No. U1604284).

摘　　要：Background: Immunoglobulin A nephropathy (IgAN) is the most common pathological type of glomerular disease. Kidney biopsy, the gold standard for IgAN diagnosis, has not been routinely applied in hospitals worldwide due to its invasion nature. Thus, we aim to establish a non-invasive diagnostic model and determine markers to evaluate disease severity by analyzing the serological parameters and pathological stages of patients with IgAN. Methods: A total of 272 biopsy-diagnosed IgAN inpatients and 518 non-IgA nephropathy inpatients from the Department of Nephrology of Chinese People's Liberation Army General Hospital were recruited for this study. Routine blood examination, blood coagulation testing, immunoglobulin-complement testing, and clinical biochemistry testing were conducted and pathological stages were analyzed according to Lee grading system. The serological parameters and pathological stages were analyzed. The receiver operating characteristic (ROC) analysis was performed to estimate the diagnostic value of the clinical factors. Logistic regression was used to establish the diagnostic model. Results: There were 15 significantly different serological parameters between the IgAN and non-IgAN groups (all P< 0.05). The ROC analysis was performed to measure the diagnostic value for IgAN of these parameters and the results showed that the area under the ROC curve (AUC) of total protein (TP), total cholesterol (TC), fibrinogen (FIB), D-dimer (D2), immunoglobulin A (IgA), and immunoglobulin G (IgG) were more than 0.70. The AUC of the "TC + FIB + D2 + IgA + age" combination was 0.86, with a sensitivity of 85.98% and a specificity of 73.85%. Pathological grades of Ⅰ,Ⅱ,Ⅲ,Ⅳ, and Ⅴ accounted for 2.21 %, 17.65%, 62.50%, 11.76%, and 5.88%, respectively, with grade Ⅲ being the most prevalent. The levels of urea nitrogen (UN)(13.57土 5.95 vs. 6.06 土 3.63, 5.92 + 2.97, 5.41 ± 1.73, and 8.41 ±3.72μmol/L, respectively) and creatinine (Cr)(292.19± 162.21 vs. 80.42±24.75, 103.79±72.72, 96.41 ±33.79, and 1

关 键 词：IMMUNOGLOBULIN A NEPHROPATHY NONINVASIVE DIAGNOSTIC model SEVERITY 

分 类 号：R[医药卫生]