Blood markers reveal severity of common kidney disease

Results could help diagnose and manage patients

2012-08-17

(Press-News.org) Highlights The blood levels of certain abnormal proteins and the antibodies that attack them rise according to the severity of one of the most common diseases of the kidney. The findings may help in the diagnosis and management of the disease, called IgA nephropathy.

IgA nephropathy can lead to high blood pressure, swelling and, in some cases, kidney failure.

Washington, DC (August 16, 2012) — Increasing blood levels of particular proteins may act as warning signs for patients with one of the most common diseases of the kidney, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The findings could lead to better diagnosis and management of patients with the disease, called IgA nephropathy.

IgA nephropathy occurs when IgA1, a protein that helps the body fight certain infections, becomes modified and settles in the kidneys. This 'first hit' of the disease is followed by a 'second hit' when the patient's immune system mounts an antibody response against these modified IgA1 molecules. Over time, these events can damage the kidneys, which subsequently leak blood and protein in the urine, and can lead to hypertension and kidney failure.

To better characterize the disease, Francois Berthoux, MD (University Hospital of Saint-Etienne, France), Jan Novak, MD, PhD (University of Alabama at Birmingham), Hitoshi Suzuki, MD, PhD (Juntendo University, in Tokyo, Japan), and their colleagues studied blood samples from 97 patients with IgA nephropathy and compared them with samples from 60 individuals without the disease. They found that blood levels of both modified IgA1 and the antibodies that target them increased in a stepwise fashion according to the severity of patients' disease. Also, patients with highest blood levels of antibodies against modified IgA1 at the time of diagnosis had the highest risks of eventually needing dialysis due to kidney failure and of dying prematurely.

"This paper is a first step, and in the future we have to refine these tests to check the impact of different treatments on these serum biomarkers, and to imagine new therapies with direct impacts on modified IgA1 or on the specific antibody responses against it," said Dr. Berthoux.

###Study co-authors include Lise Thibaudin, MD, Nicolas Maillard, MD, PhD, Christophe Mariat, MD, PhD (University Hospital of Saint-Etienne, France); Hiroyuki Yanagawa MD, PhD; Yasuhiko Tomino, MD, PhD (Juntendo University, in Tokyo, Japan); and Bruce Julian, MD, PhD (University of Alabama at Birmingham).

Disclosures: The authors reported no financial disclosures.

The article, entitled " Autoantibodies targeting galactose-deficient IgA1 associate with progression of IgA nephropathy," will appear online at http://jasn.asnjournals.org/ on August 16, 2012, doi: 10.1681/ASN.2012010053.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

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