The complex of immunoglobulin A and uromodulin as a diagnostic marker for immunoglobulin A nephropathyReport as inadecuate

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Clinical and Experimental Nephrology

, Volume 16, Issue 5, pp 713–721

First Online: 14 March 2012Received: 05 December 2011Accepted: 21 February 2012


BackgroundThe only tool to diagnose immunoglobulinn A nephropathy IgAN is renal biopsy which requires hospitalization; moreover, renal biopsy has a risk of critical bleeding. Therefore, a non-invasive method for accurate diagnosis of IgAN is desirable and a must-to-have tool for the clinics. For this purpose, we evaluated the diagnostic value of the IgA–uromodulin complex in the urine of patients with IgAN for its feasibility and adequacy.

MethodWe determined the IgA–uromodulin complex as a candidate for a diagnostic marker of IgAN by immunoprecipitation, liquid chromatography−mass spectrometry LC–MS and Western blot analysis. The enzyme-linked immunosorbent assay ELISA for the IgA–uromodulin complex was developed and applied to urine samples obtained from various kidney disease patients.

ResultOne hundred and three of 126 urine samples 81.7% from IgAN patients were positive for the IgA–uromodulin complex, while only 25 out of 94 urine samples 26.6% in other kidney disease patients were positive. Sensitivity was 81.7%, specificity was 73.4%, and diagnosis efficiency was 78.2%. The complex was negative in eight urine samples obtained from patients with Alport syndrome which is almost impossible to discriminate from IgAN by routine urinalysis.

ConclusionDetection of the urinary IgA–uromodulin complex by ELISA is a useful non-invasive method to diagnose IgAN.

KeywordsIgA nephropathy Diagnosis Uromodulin Immune complex ELISA  Download fulltext PDF

Author: Takashi Obara - Sadaaki Mizoguchi - Yasunori Shimozuru - Toshitaka Sato - Osamu Hotta


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