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Serum IL-18 is closely associated with renal tubulointerstitial injury and predicts renal prognosis in IgA nephropathy.

Shi B, Ni Z, Cao L, Zhou M, Mou S, Wang Q, Zhang M, Fang W, Yan Y, Qian J - Mediators Inflamm. (2012)

Bottom Line: Baseline serum IL-18 levels were significantly correlated with urinary protein excretion (r = 0.494, P = 0.002), Scr (r = 0.61, P < 0.001), and eGFR (r = -0.598, P < 0.001).During follow-up, 26 patients (34.21%) had a declined renal function.Kaplan-Meier analysis found those patients with elevated IL-18 had a significant poor renal outcome (P = 0.03), and Cox analysis further confirmed that serum IL-18 levels were an independent predictor of renal prognosis (β = 1.98, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Road, Shanghai 200127, China.

ABSTRACT

Background: IgA nephropathy (IgAN) was thought to be benign but recently found it slowly progresses and leads to ESRD eventually. The aim of this research is to investigate the value of serum IL-18 level, a sensitive biomarker for proximal tubule injury, for assessing the histopathological severity and disease progression in IgAN.

Methods: Serum IL-18 levels in 76 IgAN patients and 36 healthy blood donors were measured by ELISA. We evaluated percentage of global and segmental sclerosis (GSS) and extent of tubulointerstitial damage (TID). The correlations between serum IL-18 levels with clinical, histopathological features and renal prognosis were evaluated.

Results: The patients were 38.85 ± 10.95 years old, presented with 2.61 (1.43∼4.08) g/day proteinuria. Serum IL-18 levels were significantly elevated in IgAN patients. Baseline serum IL-18 levels were significantly correlated with urinary protein excretion (r = 0.494, P = 0.002), Scr (r = 0.61, P < 0.001), and eGFR (r = -0.598, P < 0.001). TID scores showed a borderline significance with serum IL-18 levels (r = 0.355, P = 0.05). During follow-up, 26 patients (34.21%) had a declined renal function. Kaplan-Meier analysis found those patients with elevated IL-18 had a significant poor renal outcome (P = 0.03), and Cox analysis further confirmed that serum IL-18 levels were an independent predictor of renal prognosis (β = 1.98, P = 0.003).

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In patients respond to corticosteroid therapy (R group), sIL-18 decreased significantly both in responders and nonresponders (P < 0.05) while NRs patients showed much higher baseline IL-18 levels (P = 0.02).
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fig2: In patients respond to corticosteroid therapy (R group), sIL-18 decreased significantly both in responders and nonresponders (P < 0.05) while NRs patients showed much higher baseline IL-18 levels (P = 0.02).

Mentions: After corticosteroid therapy, 29 patients showed CR and 22 patients showed PR, totally 51 patients were deemed responders (R) group (effective rate 67.10%). Those who showed NR to steroid were deemed non-responders (NR). The clinical and histological characteristics of the R and NR patients at the time of enrollment are shown in Table 2. There were no differences between the two groups with respect to age, gender, blood pressure, serum albumin, lipids, hemoglobin, sIgA, renal function, and GGS, whereas NRs showed higher TID scores than Rs (P = 0.04). After 12 months therapy, serum IL-18 levels decreased significantly both in the Rs (P < 0.01) and NRs (P = 0.01) (Figure 2), while NRs patients showed much higher baseline IL-18 levels (384.06 ± 15.10 versus 348.35 ± 37.05, P = 0.02). Multivariate regression analysis model which introduces all clinical and histological parameters showed that serum IL-18 levels (β = −0.003, P = 0.01), serum albumin level (β = 0.469, P = 0.04), and TID scores (β = −0.236, P = 0.018) were significantly correlated with corticosteroid responsiveness (Table 3).


Serum IL-18 is closely associated with renal tubulointerstitial injury and predicts renal prognosis in IgA nephropathy.

Shi B, Ni Z, Cao L, Zhou M, Mou S, Wang Q, Zhang M, Fang W, Yan Y, Qian J - Mediators Inflamm. (2012)

In patients respond to corticosteroid therapy (R group), sIL-18 decreased significantly both in responders and nonresponders (P < 0.05) while NRs patients showed much higher baseline IL-18 levels (P = 0.02).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3306983&req=5

fig2: In patients respond to corticosteroid therapy (R group), sIL-18 decreased significantly both in responders and nonresponders (P < 0.05) while NRs patients showed much higher baseline IL-18 levels (P = 0.02).
Mentions: After corticosteroid therapy, 29 patients showed CR and 22 patients showed PR, totally 51 patients were deemed responders (R) group (effective rate 67.10%). Those who showed NR to steroid were deemed non-responders (NR). The clinical and histological characteristics of the R and NR patients at the time of enrollment are shown in Table 2. There were no differences between the two groups with respect to age, gender, blood pressure, serum albumin, lipids, hemoglobin, sIgA, renal function, and GGS, whereas NRs showed higher TID scores than Rs (P = 0.04). After 12 months therapy, serum IL-18 levels decreased significantly both in the Rs (P < 0.01) and NRs (P = 0.01) (Figure 2), while NRs patients showed much higher baseline IL-18 levels (384.06 ± 15.10 versus 348.35 ± 37.05, P = 0.02). Multivariate regression analysis model which introduces all clinical and histological parameters showed that serum IL-18 levels (β = −0.003, P = 0.01), serum albumin level (β = 0.469, P = 0.04), and TID scores (β = −0.236, P = 0.018) were significantly correlated with corticosteroid responsiveness (Table 3).

Bottom Line: Baseline serum IL-18 levels were significantly correlated with urinary protein excretion (r = 0.494, P = 0.002), Scr (r = 0.61, P < 0.001), and eGFR (r = -0.598, P < 0.001).During follow-up, 26 patients (34.21%) had a declined renal function.Kaplan-Meier analysis found those patients with elevated IL-18 had a significant poor renal outcome (P = 0.03), and Cox analysis further confirmed that serum IL-18 levels were an independent predictor of renal prognosis (β = 1.98, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Renal Division, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Road, Shanghai 200127, China.

ABSTRACT

Background: IgA nephropathy (IgAN) was thought to be benign but recently found it slowly progresses and leads to ESRD eventually. The aim of this research is to investigate the value of serum IL-18 level, a sensitive biomarker for proximal tubule injury, for assessing the histopathological severity and disease progression in IgAN.

Methods: Serum IL-18 levels in 76 IgAN patients and 36 healthy blood donors were measured by ELISA. We evaluated percentage of global and segmental sclerosis (GSS) and extent of tubulointerstitial damage (TID). The correlations between serum IL-18 levels with clinical, histopathological features and renal prognosis were evaluated.

Results: The patients were 38.85 ± 10.95 years old, presented with 2.61 (1.43∼4.08) g/day proteinuria. Serum IL-18 levels were significantly elevated in IgAN patients. Baseline serum IL-18 levels were significantly correlated with urinary protein excretion (r = 0.494, P = 0.002), Scr (r = 0.61, P < 0.001), and eGFR (r = -0.598, P < 0.001). TID scores showed a borderline significance with serum IL-18 levels (r = 0.355, P = 0.05). During follow-up, 26 patients (34.21%) had a declined renal function. Kaplan-Meier analysis found those patients with elevated IL-18 had a significant poor renal outcome (P = 0.03), and Cox analysis further confirmed that serum IL-18 levels were an independent predictor of renal prognosis (β = 1.98, P = 0.003).

Show MeSH
Related in: MedlinePlus