Relationship between Serum IgA/C3 Ratio and Progression of IgA Nephropathy

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  • KOMATSU Hiroyuki
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki
  • FUJIMOTO Shouichi
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki
  • HARA Seiichiro
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki
  • SATO Yuji
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki
  • YAMADA Kazuhiro
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki
  • ETO Tanenao
    First Department of Internal Medicine, Miyazaki Medical College, University of Miyazaki

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  Objective  The serum IgA/C3 ratio might be considered to serve as a diagnostic marker for patients with IgA nephropathy (IgAN), but its value as a marker of the severity of histological lesions or prognosis is unknown.<BR>  Methods  We studied the serum IgA/C3 ratio, using standardized reference material, in 86 patients with IgAN and in 32 with non-IgAN. The patients with IgAN were divided according to the severity of histological lesions (mild IgAN, n=29 and severe IgAN, n=57) based on Japanese clinical guidelines.<BR>  Results  The serum IgA level was significantly higher, while its C3 level was lower in patients with severe IgAN compared to those with non-IgAN. However, these levels were not different between patients with mild IgAN and non-IgAN. In contrast, the serum IgA/C3 ratio obviously differed among the three groups (2.47±0.96 vs. 3.63±1.44 vs. 4.72±1.86; p<0.01, ANOVA). Kaplan-Meier analysis of the patients with IgAN classified according to the mean serum IgA/C3 ratio revealed that the group with high serum IgA/C3 (4.5 and above) had a significantly poorer renal outcome (p<0.05, log-rank test), since the cumulative renal survival rate at 5 years was 84.4% vs. 100%. The ratio (%) of patients with severe IgAN in whom hematuria disappeared, was significantly higher in the low, than in the high serum IgA/C3 group (41.9% vs. 15.4%; p<0.05, t-test).<BR>  Conclusion  The serum IgA/C3 ratio appears to reflect the histological severity of IgAN and could serve as a marker of the progression of IgAN.

Journal

  • Internal Medicine

    Internal Medicine 43 (11), 1023-1028, 2004

    The Japanese Society of Internal Medicine

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