TY - JOUR
T1 - Association between serum albumin level and incidence of end-stage renal disease in patients with Immunoglobulin A nephropathy
T2 - A possible role of albumin as an antioxidant agent
AU - Kawai, Yasuhiro
AU - Masutani, Kosuke
AU - Torisu, Kumiko
AU - Katafuchi, Ritsuko
AU - Tanaka, Shigeru
AU - Tsuchimoto, Akihiro
AU - Mitsuiki, Koji
AU - Tsuruya, Kazuhiko
AU - Kitazono, Takanari
N1 - Funding Information:
We would like to thank the following investigators at the participating institutions: Drs Tetsu-hiko Yoshida (Hamanomachi Hospital), Kei Hori (Munakata Medical Association Hospital), Takashi Inenaga (Japan Seafarers Relief Association Moji Ekisaikai Hospital), Akinori Naga-shima (Japanese Red Cross Karatsu Hospital) and Tadashi Hirano (Hakujyuji Hospital) for patient recruitment, treatment and follow-up. We also thank Ms. Hideko Noguchi for her technical assistance. Moreover, we appreciate the technical assistance from The Research Support Center, Research Center for Human Disease Modeling, Kyushu University Graduate School of Medical Sciences.
Publisher Copyright:
© 2018 Kawai et al. 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 credited.
PY - 2018/5
Y1 - 2018/5
N2 - Serum albumin is the major intravascular antioxidant. Though oxidative stress plays an important role in the pathophysiology of Immunoglobulin A nephropathy (IgAN), the association between serum albumin and the progression of IgAN is not entirely understood. This retrospective cohort study of 1,352 participants with biopsy-proven IgAN determined the associations between serum albumin level and the incidence of end-stage renal disease (ESRD) using a Cox proportional hazards model. Patients were divided into three groups by tertiles of serum albumin level: Low, Middle, and High group (3.9 g/dL, 4.0–4.3 g/dL, 4.4 g/dL, respectively). During the median 5.1-year follow-up period, 152 patients (11.2%) developed ESRD. Participants in the Low group had a 1.88-fold increased risk for ESRD compared with those in the High group after adjustment for clinical parameters, including urinary protein excretion, and pathological parameters (Oxford classification). We also experimentally proved the antioxidant capacity of albumin on mesangial cells. The intracellular reactive oxygen species and mitochondrial injury, induced by hydrogen peroxide were significantly attenuated in albumin-pretreated mouse mesangial cells and human kidney cells compared with γ-globulin-pretreated cells. Low serum albumin level is an independent risk factor for ESRD in patients with IgAN. The mechanism could be explained by the antioxidant capacity of serum albumin.
AB - Serum albumin is the major intravascular antioxidant. Though oxidative stress plays an important role in the pathophysiology of Immunoglobulin A nephropathy (IgAN), the association between serum albumin and the progression of IgAN is not entirely understood. This retrospective cohort study of 1,352 participants with biopsy-proven IgAN determined the associations between serum albumin level and the incidence of end-stage renal disease (ESRD) using a Cox proportional hazards model. Patients were divided into three groups by tertiles of serum albumin level: Low, Middle, and High group (3.9 g/dL, 4.0–4.3 g/dL, 4.4 g/dL, respectively). During the median 5.1-year follow-up period, 152 patients (11.2%) developed ESRD. Participants in the Low group had a 1.88-fold increased risk for ESRD compared with those in the High group after adjustment for clinical parameters, including urinary protein excretion, and pathological parameters (Oxford classification). We also experimentally proved the antioxidant capacity of albumin on mesangial cells. The intracellular reactive oxygen species and mitochondrial injury, induced by hydrogen peroxide were significantly attenuated in albumin-pretreated mouse mesangial cells and human kidney cells compared with γ-globulin-pretreated cells. Low serum albumin level is an independent risk factor for ESRD in patients with IgAN. The mechanism could be explained by the antioxidant capacity of serum albumin.
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U2 - 10.1371/journal.pone.0196655
DO - 10.1371/journal.pone.0196655
M3 - Article
C2 - 29795559
AN - SCOPUS:85047420425
VL - 13
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 5
M1 - e0196655
ER -