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Markers for the progression of IgA nephropathy

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Abstract

We have summarized the latest findings on markers for progression of immunoglobulin A (IgA) nephropathy (IgAN), the most common primary glomerulonephritis with a high prevalence among end-stage renal disease (ESRD) patients. The clinical predictors of renal outcome in IgAN nephropathy, such as proteinuria, hypertension, and decreased estimated glomerular filtration rate (eGFR) at the time of the diagnosis, are well known. The Oxford classification of IgAN identified four types of histological lesions (known as the MEST score) associated with the development of ESRD and/or a 50 % reduction in eGFR. In addition, the role of genetic risk factors associated with IgAN is being elucidated by genome-wide association studies, with multiple risk alleles described. Recently, biomarkers in serum (galactose-deficient IgA1, IgA/IgG autoantibodies against galactose-deficient IgA1, and soluble CD 89-IgA complexes) and urine (soluble transferrin receptor, interleukin-6/epidermal growth factor ratio, fractalkine, laminin G-like 3 peptide, κ light chains, and mannan-binding lectin) have been identified. Some of these biomarkers may represent candidates for the development of noninvasive diagnostic tests, that would be useful for detection of subclinical disease activity, monitoring disease progression, assessment of treatment, and at the same time circumventing the complications associated with renal biopsies. These advances, along with future disease-specific therapy, will be helpful in improving the treatment effectiveness, prognosis, and the quality of life in connection with IgAN.

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Acknowledgments

The authors CR, QB, and JN have been supported in part by Grants DK106341, DK079337, DK078244, DK082753, GM098539 from the National Institutes of Health and a gift from the IGA Nephropathy Foundation of America and the authors DM and VT by Grant LH15168 from the Ministry of Education, Youth and Sports of the Czech Republic.

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    Authors and Affiliations

    1. Department of Nephrology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague 2, Czech Republic

      Dita Maixnerova, Michaela Neprasova & Vladimir Tesar

    2. Departments of Microbiology and Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA

      Colin Reily, Qi Bian & Jan Novak

    3. Department of Nephrology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China

      Qi Bian

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    1. Dita Maixnerova
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    Correspondence to Dita Maixnerova.

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    D. Maixnerova, C. Reily and Q. Bian contributed equally to this review.

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    Maixnerova, D., Reily, C., Bian, Q. et al. Markers for the progression of IgA nephropathy. J Nephrol 29, 535–541 (2016). https://doi.org/10.1007/s40620-016-0299-0

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