The Effectiveness of the Serum IgA Level in Diagnosing IgA Nephropathy

Abstract

Background: Immunoglobulin A(IgA) nephropathy is the most common primary glonerular disease throughout the world. 30-50% of patients with IgA nephropathy(IgAN) have high serum IgA concentrations. However, we do not know if the defree of elevation

in IgA level increases the likelihood of having IgAN. Neither do we know if the IgA level has any association with pathological finding of IgAN.

Methods: We analyzed the relationships between IgAN and the levels of serum IgA which has been a routine part of the study in all patients with glomerulonephritis in our institution for the last 4 years. We reviewed 270 patients in whom the

pathological diagnosis and the results of their IgA levels were both available.

Results: Of 80 patients who were IgA nephropathy, 26 patients(32.5%) had higher than normal cut-off value of serum IgA(365 ㎎/㎗). In contrast, 8.9% of patients with other types of glomerulonephropathies showed the values above normal(p<0.001).

The risk ratio for an increase of one unit of the IgA level was 1.0025(logistic regression, p=0.0043), which was increased to 1.0079 when patients with low complement levels were excluded from the analysis. The data were also analyzed according to the

immunofluorescence micreoscopic findings of IgAN, which were found to have no significant correlation with IgA concentrations.

Conclusions: The IgA level is a risk factor for IgAN throughout the whole range. However, it does not correlate with the IgA deposition in the renal tissue. We believe that this study will help understanding the interpretation of IgA levels in patients with IgAN.