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Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study

The circulating tumor necrosis factor receptors (TNFRs) could predict the long-term renal outcome in diabetes, but the role of circulating TNFRs in other chronic kidney disease has not been reported. Here, we investigated the correlation between circulating TNFRs and renal histologic findings on kid...

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Autores principales: Oh, Yun Jung, An, Jung Nam, Kim, Clara Tammy, Yang, Seung Hee, Lee, Hajeong, Kim, Dong Ki, Joo, Kwon Wook, Paik, Jin Ho, Kang, Shin-Wook, Park, Jung Tak, Lim, Chun Soo, Kim, Yon Su, Lee, Jung Pyo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503615/
https://www.ncbi.nlm.nih.gov/pubmed/26177311
http://dx.doi.org/10.1371/journal.pone.0132826
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author Oh, Yun Jung
An, Jung Nam
Kim, Clara Tammy
Yang, Seung Hee
Lee, Hajeong
Kim, Dong Ki
Joo, Kwon Wook
Paik, Jin Ho
Kang, Shin-Wook
Park, Jung Tak
Lim, Chun Soo
Kim, Yon Su
Lee, Jung Pyo
author_facet Oh, Yun Jung
An, Jung Nam
Kim, Clara Tammy
Yang, Seung Hee
Lee, Hajeong
Kim, Dong Ki
Joo, Kwon Wook
Paik, Jin Ho
Kang, Shin-Wook
Park, Jung Tak
Lim, Chun Soo
Kim, Yon Su
Lee, Jung Pyo
author_sort Oh, Yun Jung
collection PubMed
description The circulating tumor necrosis factor receptors (TNFRs) could predict the long-term renal outcome in diabetes, but the role of circulating TNFRs in other chronic kidney disease has not been reported. Here, we investigated the correlation between circulating TNFRs and renal histologic findings on kidney biopsy in IgA nephropathy (IgAN) and assessed the notion that the circulating TNFRs could predict the clinical outcome. 347 consecutive biopsy-proven IgAN patients between 2006 and 2012 were prospectively enrolled. Concentrations of circulating TNFRs were measured using serum samples stored at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; ≥ 30% decline compared to baseline). Mean eGFR decreased and proteinuria worsened proportionally as circulating TNFR1 and TNFR2 increased (P < 0.001). Tubulointerstitial lesions such as interstitial fibrosis and tubular atrophy were significantly more severe as concentrations of circulating TNFRs increased, regardless of eGFR levels. The risks of reaching the primary endpoint were significantly higher in the highest quartile of TNFRs compared with other quartiles by the Cox proportional hazards model (TNFR1; hazard ratio 7.48, P < 0.001, TNFR2; hazard ratio 2.51, P = 0.021). In stratified analysis according to initial renal function classified by the eGFR levels of 60 mL/min/1.73 m(2), TNFR1 and TNFR2 were significant predictors of renal progression in both subgroups. In conclusion, circulating TNFRs reflect the histology and clinical severity of IgAN. Moreover, elevated concentrations of circulating TNFRs at baseline are early biomarkers for subsequent renal progression in IgAN patients.
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spelling pubmed-45036152015-07-17 Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study Oh, Yun Jung An, Jung Nam Kim, Clara Tammy Yang, Seung Hee Lee, Hajeong Kim, Dong Ki Joo, Kwon Wook Paik, Jin Ho Kang, Shin-Wook Park, Jung Tak Lim, Chun Soo Kim, Yon Su Lee, Jung Pyo PLoS One Research Article The circulating tumor necrosis factor receptors (TNFRs) could predict the long-term renal outcome in diabetes, but the role of circulating TNFRs in other chronic kidney disease has not been reported. Here, we investigated the correlation between circulating TNFRs and renal histologic findings on kidney biopsy in IgA nephropathy (IgAN) and assessed the notion that the circulating TNFRs could predict the clinical outcome. 347 consecutive biopsy-proven IgAN patients between 2006 and 2012 were prospectively enrolled. Concentrations of circulating TNFRs were measured using serum samples stored at the time of biopsy. The primary clinical endpoint was the decline of estimated glomerular filtration rate (eGFR; ≥ 30% decline compared to baseline). Mean eGFR decreased and proteinuria worsened proportionally as circulating TNFR1 and TNFR2 increased (P < 0.001). Tubulointerstitial lesions such as interstitial fibrosis and tubular atrophy were significantly more severe as concentrations of circulating TNFRs increased, regardless of eGFR levels. The risks of reaching the primary endpoint were significantly higher in the highest quartile of TNFRs compared with other quartiles by the Cox proportional hazards model (TNFR1; hazard ratio 7.48, P < 0.001, TNFR2; hazard ratio 2.51, P = 0.021). In stratified analysis according to initial renal function classified by the eGFR levels of 60 mL/min/1.73 m(2), TNFR1 and TNFR2 were significant predictors of renal progression in both subgroups. In conclusion, circulating TNFRs reflect the histology and clinical severity of IgAN. Moreover, elevated concentrations of circulating TNFRs at baseline are early biomarkers for subsequent renal progression in IgAN patients. Public Library of Science 2015-07-15 /pmc/articles/PMC4503615/ /pubmed/26177311 http://dx.doi.org/10.1371/journal.pone.0132826 Text en © 2015 Oh et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Oh, Yun Jung
An, Jung Nam
Kim, Clara Tammy
Yang, Seung Hee
Lee, Hajeong
Kim, Dong Ki
Joo, Kwon Wook
Paik, Jin Ho
Kang, Shin-Wook
Park, Jung Tak
Lim, Chun Soo
Kim, Yon Su
Lee, Jung Pyo
Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title_full Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title_fullStr Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title_full_unstemmed Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title_short Circulating Tumor Necrosis Factor α Receptors Predict the Outcomes of Human IgA Nephropathy: A Prospective Cohort Study
title_sort circulating tumor necrosis factor α receptors predict the outcomes of human iga nephropathy: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503615/
https://www.ncbi.nlm.nih.gov/pubmed/26177311
http://dx.doi.org/10.1371/journal.pone.0132826
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