Time-averaged albumin predicts the long-term prognosis of IgA nephropathy patients who achieved remission.
Time-averaged albumin predicts the long-term prognosis of IgA nephropathy patients who achieved remission.
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时间平均白蛋白预测获得缓解的 IgA 肾病患者的长期预后
DOI：
10.1186/1479-5876-12-194
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发表时间：
2014-07-10
影响因子：
7.4
通讯作者：
Mou S
中科院分区：
文献类型：
--
作者：
Ni Z;Yuan Y;Wang Q;Cao L;Che X;Zhang M;Xie Y;Qi C;Mou S
研究背景原发性伊加肾病（IgAN）是世界范围内最常见的特发性肾小球肾炎。尽管大多数患者能够通过当前治疗获得缓解，但大量患者仍将进展为终末期肾病。本研究的目的是评估肾脏疾病进展和危险因素进展的IgAN患者谁实现remission.MethodsPatients从一个前瞻性的数据库与IgAN被列入本研究。所有受试者在治疗6个月后均达到完全缓解（CR）或部分缓解（PR）。肾存活率和临床参数和复合肾outcomes之间的关系进行了assessed.ResultsThe研究包括2005年1月至2010年12月招募878 IgAN患者。总共有632例患者入组本研究。分析了369例达到缓解的患者的数据;平均随访时间为49个月。基线时中位血清肌酐（SCr）浓度为91.3 μmol/L，时间平均肌酐（TA-SCr）为91.8 μmol/L。基线时平均血清白蛋白（ALB）水平为39.4 g/L，时间平均血清白蛋白（TA-ALB）为42.1 g/L。多变量考克斯回归分析显示，TA-ALB和TA-SCr水平与复合肾脏结局独立相关。TA-SCr值> 120 μmol/L和TA-ALB值< 38 g/L的患者不太可能从肾进展中恢复。结论本研究中观察到的低TA-ALB和高TA-SCr水平与进展的强预测关系表明，TA-ALB可作为IgAN患者的长期肾预后的标志物。
BackgroundPrimary IgA nephropathy (IgAN) is the most common form of idiopathic glomerulonephritis worldwide. Although most patients are able to achieve remission with the current therapy, a large number of patients will still progress to end-stage renal disease. This study aimed to evaluate kidney disease progression and the risk factors for progression in IgAN patients who achieved remission.MethodsPatients from a prospective database with IgAN were included in this study. All the subjects had achieved a complete remission (CR) or partial remission (PR) following 6 months of therapy. Renal survival and the relationship between the clinical parameters and composite renal outcomes were assessed.ResultsThe study comprised 878 IgAN patients recruited between January 2005 and December 2010. Overall, 632 patients were enrolled in this study. The data from the 369 patients who achieved remission were analyzed; the mean follow-up time was 49 months. The median serum creatinine (SCr) concentration at baseline was 91.3 μmol/L, and the time-averaged creatinine (TA-SCr) was 91.8 μmol/L. The mean serum albumin (ALB) level at baseline was 39.4 g/L, and the time-averaged serum albumin (TA-ALB) was 42.1 g/L. Multivariate Cox regression analyses revealed that the TA-ALB and TA-SCr levels were independently associated with the composite renal outcome. The patients with a TA-SCr value > 120 μmol/L and a TA-ALB level < 38 g/L were less likely to recover from renal progression.ConclusionThe strong predictive relationship of low TA-ALB and high TA-SCr levels with progression observed in this study suggests that TA-ALB may serve as a marker of the long-term renal prognosis of IgAN patients who have achieved remission.
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DOI：
10.1093/ndt/gfp273
发表时间：
2009-10
期刊：
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
影响因子：
--
作者：
Goto M;Wakai K;Kawamura T;Ando M;Endoh M;Tomino Y
通讯作者：
Tomino Y
影响因子：
13.2
作者：
Bartosik, LP;Lajoie, G;Cattran, DC
通讯作者：
Cattran, DC
影响因子：
--
作者：
Mackinnon, Bruce;Fraser, Emily P.;Geddes, Colin C.
通讯作者：
Geddes, Colin C.
影响因子：
13.2
作者：
Koyama, A;Igarashi, M;Kobayashi, M
通讯作者：
Kobayashi, M
影响因子：
6.1
作者：
Geddes, CC;Rauta, V;Cattran, DC
通讯作者：
Cattran, DC