Correlation Between SuPAR Protein Concentration In Serum And Urine And Severity And Prognosis Of Primary IgA Nephropathy

The incidence of IgA nephropathy(IgAN)is increasing year by year.In recent years,plasma and urine biomarkers of IgA nephropathy have gradually become a research hotspot.SuPAR protein can be detected in blood and urine,and the content remains stable.Previous studies have shown that suPAR protein is the pathogenic factor of primary FSGS lesions,and focal segmental sosclerosis lesions in primary IgA nephropathy,namely S lesions,have FSGS-like lesions.The two diseases may have similar pathogenesis.In addition,studies have found that eGFR decreases significantly faster in patients with IgA nephropathy with S lesion.Objective: The purpose of this study was to further understand the role of plasma and urine suPAR protein concentrations in assessing the severity and efficacy of primary IgA nephropathy.To investigate the correlation between suPAR protein and S lesions and whether suPAR protein can distinguish IgA nephropathy with and without S lesions,so as to evaluate the S lesions and prognosis of IgAN patients.Methods: A total of 102 patients underwent renal biopsy for the first time in Shaanxi Provincial People’s Hospital were included in this study,and none of the subjects began hormone and immunosuppressive therapy.Some patients were followed up for at least 12 months after treatment.Among them,50 patients in the experimental group with primary IgAN,42 patients in the experimental control group with non-IgAN primary glomerulonephritis,and 10 patients in the healthy control group were selected.Fasting blood and urine samples were collected before treatment in each group,and urine sampleswere collected at 3 months,6 months and 1 year after treatment of primary IgAN group.Plasma and urine suPAR protein concentrations were determined by elisa.In addition,general information and clinically relevant indicators of each group were collected,including serum creatinine,urea nitrogen,quantitative 24 urine protein,albumin,blood lipid,blood routine,etc.,to analyze the relationship between plasma and urine suPAR protein concentrations and each clinically relevant indicator.The data were analyzed by SPSS23.0 software.Results:1.Correlation of serum suPAR protein concentration with severity and prognosis of primary IgAN1.1The plasma su-PAR protein concentration in patients with primary IgAN was correlated with T(tubuloatrophy/interstitial fibrosis)lesions in the Oxford type(P<0.05),and showed higher su-PAR levels with more severe T lesions.However,there was no correlation with S(segmental glomerulosclerosis)(P>0.05).1.2In primary IgAN patients,plasma su-par protein concentration was negatively correlated with eGFR(r < 0),and positively correlated with CREA and 24-hour urinary protein quantification(r >0).1.3 With the increasing CKD stage and WHO grading of chronic kidney disease,the plasma suPAR protein concentration in primary IgAN patients showed higher levels.2.Correlation between urinary suPAR protein concentration with severity and prognosis of primary IgAN2.1 Urinary Su-PAR protein concentration in primary IgAN patients was correlated with T(tubuloatrophy/interstitial fibrosis)lesions in the Oxford type(P<0.05),and the higher the degree of T lesions,the higher the su-PAR level was.The results were similar to those of plasma Su-PAR proteins.2.2 Urinary Su-PAR protein concentrations in patients with primary IgAN were correlated with S(segmental glomerulosclerosis)lesions in the Oxford classification(P<0.05),and IgA nephropathy with S lesions showed higher su-PAR levels than IgA nephropathy without S.Urine suPAR protein can help distinguish between IgAN and S lesions.2.3 Urinary su-par protein concentration in primary IgAN patients was negatively correlated with eGFR index(r < 0),and positively correlated with CREA and 24-hour urinary protein quantification(r >0).2.4 With the increasing CKD stage and WHO grading of chronic kidney disease,urinary Su-PAR protein concentration in primary IgAN patients showed higher levels.Conclusion:1.Urinary suPAR protein can assist in the assessment of S lesions and prognosis in IgAN patients.2.Plasma and urine suPAR protein concentrations can assist in the assessment of disease severity and prognosis of primary IgAN.