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Measurement of galactosyl-deficient IgA1 by the monoclonal antibody KM55 contributes to predicting patients with IgA nephropathy with high risk of long-term progression

Abstract: Backgroundandobjective:About25%ofpatientswithIgAnephropathy(IgAN)progresstostage5chronickidneydisease(CKD)afteryearsofevolution.Varioustoolshavebeendevelopedinrecentyearsdesignedtopredictwhichofthepatientswillhadpooreroutcomes.Thevalueofcirculatinggalactosyl-deficientIgA1(Gd-IgA1)hasbeenrelatedtoaworseevolutionofIgANinseveralstudies.TherearealsosomepublicationsthatrelatehigherAPRILvalueswithaworseevolution.Recently,anewmethodhasbeendevelopedthatallowsmeasuringthevalueofcirculatingGd-IgA1inasimplerwaythanthosepreviouslyavailable.TheobjectiveofthisstudyistoanalyzetheinfluenceofcirculatingGd-IgA1,measuredbythismethod,ontheprogressionofIgAN.Materialsandmethods:Forty-ninepatientswithadiagnosisofIgANdemonstratedbyrenalbiopsywereselectedinourcenter,withouthavingreceivedpriorimmunosuppressivetreat-ment,forwhomfrozenserumwasavailable.Themedianfollow-upwas4years.Gd-IgA1wasmeasuredbylectin-independentELISAwiththemonoclonalantibodyKM55(IgA1kitCat.No.30111694.IBLInt.,Hamburg,Germany).Likewise,APRILlevelswerealsomeasuredinthesepatients.Results:19(38.8%)patientsreachedstage5CKD.ThefourthquartileofcirculatingGd-IgA1wasrelatedtoahighercumulativeriskofreachingstage5CKDintheKaplan?Meieranalysis(riskatthe5thyear39.4%vs.24.3%,logrankp=0.019).TheGd-IgA1valuewasrelatedto anincreasedriskofCKDstage5(HR1.147,95%CI1.035?1.270,p=0.009),regardlessofglomerularfiltrationrate,proteinuria,thepercentageofsclerosedglomeruliandthevalueofsegmentalsclerosis.WedidnotfindsignificantdifferencesintheAPRILvalues.Conclusions:ThevalueofcirculatingGd-IgA1measuredbythemonoclonalantibodyKM55isrelatedtoaworseevolutionofpatientswithIgANindependentlyofothervariables,soitcouldbeincludedinthestudyofpatientstoimprovethepredictionoftheriskofdiseaseprogression.

 Fuente: Nefrologia (Engl Ed) . 2021 May-Jun;41(3):311-320

 Editorial: Elsevier

 Año de publicación: 2021

 Nº de páginas: 10

 Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.nefroe.2021.06.004

 ISSN: 0211-6995,1989-2284

 Url de la publicación: https://doi.org/10.1016/j.nefroe.2021.06.004

Autoría

LUIS MARTIN PENAGOS

BENITO-HERNÁNDEZ, ADALBERTO

MAZÓN, JAIME

MARINA DE COS GOMEZ

VICTORIA OVIEDO, MARÍA

DAVID SAN SEGUNDO ARRIBAS