Results: The percent of glomeruli excluding global sclerosis, segmental sclerosis, crescent, and adhesion (Norm) this website and a grade of proteinuria were selected to correlate with proteinuric remission by logistic regression analysis.
ROC analysis showed that cut off points, which were critical for a dichotomous classification of proteinuric remission were 83% (AUC = 0.70) of Norm and 0.36 g/day (AUC = 0.79) of a grade of proteinuria, respectively. In next step, multivariate logistic regression model verified that the patients, whose Norm more than 83% (OR, 3.04; 95% CI, 1.12–8.25; p < 0.05) and whose grade of proteinuria less than 0.36 g/day (OR, 9.76; 95% CI, 2.71–35.1; p < 0.01) were independent prognostic parameters for proteinuric remission.
Equation curve predicting proteinuric remission was produced using regression coefficient of 2 parameters as follows; Logit P = fpu(x) + f Norm (x) + Constant (fpu (0) = 0, fpu (1) = 2, f Norm (0) = 0, f Norm (1) = 1; Pu(0) < 0.36 g/day, www.selleckchem.com/products/Staurosporine.html Pu(1) > = 0.36 g/day, Norm (0) > = 83%, Norm (1) < 83%. Conclusion: The prediction curve is useful for an indication of TL with SPT, because a value of Logit P constituting of number of normal glomeruli and a grade of proteinuria corresponded to a probability of proteinuric remission. KOMATSU HIROYUKI1,2, SATO YUJI1,2, MIYAMOTO TETSU2, NAKATA TAKASHI2, NISHINO TOMOYA2, TAMURA MASAHITO2, TOMO TADASHI2, MIYAZAKI MASANOBU2, FUJIMOTO SHOUICHI1,2 Urocanase 1First Department of Internal Medicine, University of Miyazaki; 2Steering committee for IgA nephropathy from four universities (IgAN-4U) Introduction: Our previous multicenter cohort study of 323 patients (JASN 2012: 23; 58A) found that tonsillectomy plus steroid pulse therapy (TSP) can result in clinical remission (CR) for patients with IgA nephropathy and mild to moderate histological
damage. Medical intervention for patients with IgA nephropathy and mild proteinuria (<1.0 g/day) is controversial, and the effectiveness of TSP for such patients remains obscure. Methods: Fifty-five patients who had mild proteinuria (0.4 to 1.0 g/day) at diagnosis and who were initially treated with steroid were eligible to participate in this study. We used univariate and multivariate analysis to evaluate the decline in renal function defined as a 100% increase in serum creatinine (sCr) and CR defined as the disappearance of hematuria and proteinuria (UP/Ucr < 0.3) between groups treated with TSP and steroid without tonsillectomy (ST). Results: Background factors at diagnosis including age (mean, 31.9 vs. 34.0 y), ratio (%) of patients with hypertension (19.6% vs. 22.2%), sCr (mean, 0.74 vs. 0.86 mg/dL), proteinuria (mean, 0.62 vs 0.69 g/day), and histological severity did not statistically differ between the TSP and ST groups. None of the patients achieved a 100% increase in sCr during mean followed–up periods of 4.5 years.