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- The clinical significance of circulating microRNA-21 in patients with IgA nephropathy
- A Young Cho, Ju Hwan Oh, Kwang Young Lee, In O Sun
- Kosin Med J. 2022;37(3):242-248. Published online September 27, 2022
- DOI: https://doi.org/10.7180/kmj.22.116
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Abstract
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- Background
Urinary microRNA-21 (miR-21) has been reported to correlate with the histologic lesions of IgA nephropathy (IgAN). We investigated whether urinary or circulating miR-21 could serve as a biomarker for detecting the renal progression of IgAN.
Methods
Forty patients with biopsy-proven IgAN were enrolled in this study. Serum and urinary sediment miRs were extracted, and the expression of miR-21 was quantified by real-time quantitative polymerase chain reaction. Renal progression was defined as end-stage renal disease, a sustained doubling of serum creatinine, or a 50% decrease in estimated glomerular filtration rate (eGFR) from baseline.
Results
Six patients experienced renal progression during the follow-up period. The baseline eGFR was lower in the progression group (49±11 mL/min/1.73 m2 vs. 90±23 mL/min/1.73 m2, p<0.05) than in the non-progression group. The level of circulating miR-21 on kidney biopsy was higher in the progression group than in the non-progression group (40.0±0.6 vs. 38.2±1.1 ΔCt value of miR-21, p<0.01), whereas there was no significant difference in urinary miR-21 (38.1±2.1 vs. 37.8±1.4 ΔCt value of miR-21, p=0.687) between the two groups. Receiver operating characteristic curve analysis demonstrated that circulating miR-21 had good discriminative power for diagnosing renal progression of IgAN, with an area under the curve of 0.975.
Conclusions
The level of circulating miR-21 was higher in the progression group than in the non-progression group at the time of kidney biopsy. Therefore, circulating miR-21 could be a surrogate marker of renal progression in patients with IgAN.
- Clinical Usefulness of Contrast-Enhanced Computed Tomography in Patients with Non-Obstructive Acute Pyleonephritis
- In O Sun, Ji Hye Lim, Ju Hwan Oh, A Young Cho, Beum Jin Kim, Kwang Young Lee, Mi Sook Lee
- Kosin Med J. 2020;35(1):38-46. Published online June 30, 2020
- DOI: https://doi.org/10.7180/kmj.2020.35.1.38
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Abstract
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Objectives The aim of this study is to investigate the clinical utility of contrast-enhanced computed tomography (CE-CT) in patient with non-obstrcutive acute pyelonephritis (APN).
Methods From 2007 to 2013, 537 APN patients who underwent a CE-CT scan within 24 hours after hospital admission were enrolled. We divided these patients into greater (50% or greater involvment, n = 143) and lesser (less than 50% involvement, n = 394) groups based on renal parenchymal involvement in CE-CT examination. We compared clinical characteristics between two groups and analyzed the clinical value of CE-CT scan as a reliable marker for predicting clinical severity and disease course in patient with non-obstructive APN.
Results The mean estimated glomerular filtration rate was 70.6 ± 25.5 mL/min/1.73m2. Compared with patients in lesser group, the patients in greater group had lower serum albumin levels (3.5 ± 0.5 vs 3.8 ± 0.6,
P < 0.01) and longer hosptal stay (10.1 ± 4.7 vs 8.8 ± 4.5,P < 0.05). In addition, acute kidney injury (AKI) (23.1% vs 11.4%,P < 0.005) and bacteremia (36.4% vs 26.8%,P = 0.02) were frequently developed in greater group, respectively. The overall incidence of AKI was 14.8% based on RIFLE criteria. In a multivariate logistic regression analysis for predciting AKI, age, presence of diabetes mellitus and the presence of renal parenchymal involvement of greater than 50% in CE-CT were significant predictors of AKI.Conclusions The CE-CT scan could be useful to predict the clinical severity and course in non-obstructive APN patients with preserved renal function.
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