Clinical Study
The correlation between serum levels of oxidative stress indicators and renal interstitial fibrosis in patients with IgA nephropathy
Lina Ding, Lihua Wu, Xiaoling Zhou, Min Yu, Menghua Chen
Published 2019-05-15
Cite as Chin J Nephrol, 2019, 35(5): 336-341. DOI: 10.3760/cma.j.issn.1001-7097.2019.05.003
Abstract
ObjectiveTo investigate the relationship between serum levels of oxidative stress indicators and the degree of renal interstitial fibrosis in patients with IgA nephropathy (IgAN).
MethodsSeventy eight patients with confirmed primary IgAN in General Hospital of Ningxia Medical University from January 2013 to December 2014 were enrolled. The patients were divided into T0 group (n=30), T1 group (n=26) and T2 group (n=22) according to the grade of tubular atrophy/ interstitial fibrosis of Oxford pathological classification criteria for IgAN in 2009. Meanwhile, thirty cases of health examiner were enrolled as control subjects. The levels of serum malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) were detected by xanthine oxidase method, thiobarbituric acid spectrophotometry method, ultraviolet spectrophotometry method, chemical colorimetric method, respectively. The levels of serum advanced oxidation protein products (AOPPs), transforming growth factor beta 1 (TGF-β1), monocyte chemotactic protein 1 (MCP-1), transforming growth factor alpha (TGF-α), interleukin 6 (IL-6) and hypoxia inducible factor 1 alpha (HIF-1α) were detected by enzyme linked immunosorbent assay (ELISA) in all groups. Spearman correlation analysis was used to analyze the correlation between serum oxidative stress indicators and traditional risk factors of tubular atrophy/renal interstitial fibrosis. Multivariable linear regression analysis was used to analyze the correlation between oxidative stress indicators and degree of renal tubular atrophy/renal interstitial fibrosis.
ResultsThere were differences in serum levels of AOPPs, MDA, SOD, CAT and GSH-Px in IgAN patients with different degrees of renal interstitial fibrosis (all P<0.05). With the increase of renal interstitial fibrosis, the levels of AOPPs and MDA increased gradually, while the levels of SOD, CAT and GSH-Px decreased gradually. Serum AOPPs, MDA, SOD, CAT, GSH-Px concentration in IgAN patients were correlated with the mean arterial pressure (MAP), total blood protein (TP), albumin (Alb), Scr, uric acid (UA), 24-hour urinary protein volume and estimated glomerular filtration rate (eGFR). Multivariate regression analysis showed that the AOPPs levels of blood were positively correlated with MAP, Scr, UA and 24-hour urinary protein (all P<0.01), and negatively correlated with TP, Alb, eGFR (all P<0.05). The serum levels of AOPPs and MDA in IgAN patients were positively correlated with the levels of TGF-β1, MCP-1, TGF-α, IL-6 and HIF-1α. The levels of SOD, CAT and GSH-Px were negatively correlated with the levels of TGF-β1, MCP-1, TGF-α, IL-6 and HIF-1α. Multivariate stepwise regression analysis showed that the degree of renal interstitial fibrosis in IgAN patients was positively correlated with serum AOPPs level (β=0.285, P=0.001), negatively correlated with CAT (β=-0.346, P<0.001), GSH-Px (β=-0.303, P<0.001).
ConclusionsThe level of serum oxidative stress in IgAN patients is elevated and positively correlated with the degree of renal interstitial fibrosis, suggesting that oxidative stress may be involved in the occurrence and development of renal interstitial fibrosis.
Key words:
Glomerulonephritis, IgA; Oxidative stress; Fibrosis; Renal interstitial
Contributor Information
Lina Ding
Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan 750004, China
Lihua Wu
Xiaoling Zhou
Min Yu
Menghua Chen