The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study

IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide and leads to end-stage kidney disease. The proteinuria selectivity index (PSI) has been used to assess the prognosis in nephrotic syndrome, but its predictive value in patients with IgAN remains unclear. This sing...

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Main Authors: Ryunosuke Mitsuno, Takashin Nakayama, Wataru Ito, Tomomi Maruki, Ran Nakamichi, Keika Adachi, Norifumi Yoshimoto, Akihito Hishikawa, Aika Hagiwara, Shintaro Yamaguchi, Toshiaki Monkawa, Jun Yoshino, Akinori Hashiguchi, Tatsuhiko Azegami, Kaori Hayashi
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2423839
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author Ryunosuke Mitsuno
Takashin Nakayama
Wataru Ito
Tomomi Maruki
Ran Nakamichi
Keika Adachi
Norifumi Yoshimoto
Akihito Hishikawa
Aika Hagiwara
Shintaro Yamaguchi
Toshiaki Monkawa
Jun Yoshino
Akinori Hashiguchi
Tatsuhiko Azegami
Kaori Hayashi
author_facet Ryunosuke Mitsuno
Takashin Nakayama
Wataru Ito
Tomomi Maruki
Ran Nakamichi
Keika Adachi
Norifumi Yoshimoto
Akihito Hishikawa
Aika Hagiwara
Shintaro Yamaguchi
Toshiaki Monkawa
Jun Yoshino
Akinori Hashiguchi
Tatsuhiko Azegami
Kaori Hayashi
author_sort Ryunosuke Mitsuno
collection DOAJ
description IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide and leads to end-stage kidney disease. The proteinuria selectivity index (PSI) has been used to assess the prognosis in nephrotic syndrome, but its predictive value in patients with IgAN remains unclear. This single-center retrospective cohort study included patients who diagnosed with IgAN between March 2012 and March 2020. The PSI was calculated at the time of kidney biopsy. Patients were followed up from the time of kidney biopsy to kidney replacement therapy, death, transfer to another facility, or study completion. Ninety-four patients with a median age of 51 years were enrolled and divided according to the cutoff value of PSI determined by the receiver operating characteristic curve analysis into low-PSI (PSI <0.243, n = 39) and high-PSI groups (PSI ≥0.243, n = 55). The median follow-up duration was 70 months. Rates of remission of proteinuria and survival without a two-fold increase in serum creatinine were significantly better in the low-PSI group (both p < 0.01, log-rank test). Cox regression analysis showed that a low PSI was significantly associated with an increased likelihood of remission of proteinuria and hematuria (hazard ratio [HR] 1.96; 95% confidence interval [CI] 1.02–3.85 and HR 1.75; 95% CI 1.01–3.13, respectively), and a decreased risk of a two-fold increase in serum creatinine (HR 0.10; 95% CI 0.01–0.81). In conclusion, The PSI could have the potential to support the assessment of the prognosis of IgAN, in addition to established prognostic markers, by reflecting the overall glomerular permeability.
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spelling doaj-art-c4ecbeac2dc343f7934b85741fd3313c2025-08-20T03:21:31ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2423839The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort studyRyunosuke Mitsuno0Takashin Nakayama1Wataru Ito2Tomomi Maruki3Ran Nakamichi4Keika Adachi5Norifumi Yoshimoto6Akihito Hishikawa7Aika Hagiwara8Shintaro Yamaguchi9Toshiaki Monkawa10Jun Yoshino11Akinori Hashiguchi12Tatsuhiko Azegami13Kaori Hayashi14Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanMedical Education Center, Keio University School of Medicine, Tokyo, JapanMedical Education Center, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDepartment of Pathology, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanDivision of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, JapanIgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide and leads to end-stage kidney disease. The proteinuria selectivity index (PSI) has been used to assess the prognosis in nephrotic syndrome, but its predictive value in patients with IgAN remains unclear. This single-center retrospective cohort study included patients who diagnosed with IgAN between March 2012 and March 2020. The PSI was calculated at the time of kidney biopsy. Patients were followed up from the time of kidney biopsy to kidney replacement therapy, death, transfer to another facility, or study completion. Ninety-four patients with a median age of 51 years were enrolled and divided according to the cutoff value of PSI determined by the receiver operating characteristic curve analysis into low-PSI (PSI <0.243, n = 39) and high-PSI groups (PSI ≥0.243, n = 55). The median follow-up duration was 70 months. Rates of remission of proteinuria and survival without a two-fold increase in serum creatinine were significantly better in the low-PSI group (both p < 0.01, log-rank test). Cox regression analysis showed that a low PSI was significantly associated with an increased likelihood of remission of proteinuria and hematuria (hazard ratio [HR] 1.96; 95% confidence interval [CI] 1.02–3.85 and HR 1.75; 95% CI 1.01–3.13, respectively), and a decreased risk of a two-fold increase in serum creatinine (HR 0.10; 95% CI 0.01–0.81). In conclusion, The PSI could have the potential to support the assessment of the prognosis of IgAN, in addition to established prognostic markers, by reflecting the overall glomerular permeability.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2423839BiomarkerIgA nephropathyproteinuriaproteinuria selectivity index
spellingShingle Ryunosuke Mitsuno
Takashin Nakayama
Wataru Ito
Tomomi Maruki
Ran Nakamichi
Keika Adachi
Norifumi Yoshimoto
Akihito Hishikawa
Aika Hagiwara
Shintaro Yamaguchi
Toshiaki Monkawa
Jun Yoshino
Akinori Hashiguchi
Tatsuhiko Azegami
Kaori Hayashi
The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
Renal Failure
Biomarker
IgA nephropathy
proteinuria
proteinuria selectivity index
title The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
title_full The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
title_fullStr The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
title_full_unstemmed The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
title_short The proteinuria selectivity index value predicts the remission of IgA nephropathy: a retrospective cohort study
title_sort proteinuria selectivity index value predicts the remission of iga nephropathy a retrospective cohort study
topic Biomarker
IgA nephropathy
proteinuria
proteinuria selectivity index
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2423839
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