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논문분류	춘계학술대회 초록집
제목	The Clinical Significance of Urine Periostin in IgA Nephropathy
저자	Jin Ho Hwang1, Jung Nam An2, Hyun Jin Ryu3, Seung Hee Yang4, Yun Kyu Oh2, Chun Soo Lim2,Kwon Wook Joo3, Dong Ki Kim3, Yon Su Kim3, Jung Pyo Lee2
출판정보	2014; 2014(1):
키워드	IgA 신병증, 소변 페리오스틴, 섬유화
초록	Background: Periostin is in charge of tissue regeneration, fibrosis, and wound healing as a non-structural protein in extracellular matrix. However, there are only limited data in the field of nephrology. Here, we investigated the correlation between urinary periostin excretion and clinical significance including renal histologic findings in IgA nephropathy (IgAN). Methods: Between 2009 and 2012, a total of 303 patients of biopsy-proved IgAN were reviewed and 219 patients were finally enrolled. Urine periostin levels were measured by ELISA using urine samples stored at the time of kidney biopsy. We divided the patients into 3 groups by the value of urine periostin/creatinine: group 1 (undetectable), group 2 (below median value of remained patients), and group 3 (above median value of remained patients). Results: Urine periostin level was correlated with WHO classification (p<0.001), Lee SMK (p=0.002), and both of the initial and the final IDMS-MDRD GFR (p<0.001). In histological aspect, the patients with higher urine periostin/ creatinine level showed more of global sclerosis, more severe interstitial inflammation (p=0.002), and more diffuse tubular atrophy (p=0.01) and interstitial fibrosis (p=0.008). In addition, blood vessel changes such as fibrointimal thickening (p=0.003), hyaline (p=0.001), and arteriosclerosis (p<0.001) were significantly associated with urine periostin/ creatinine level. In multiple linear regression model, urine periostin/creatinine was significantly correlated with the final IDMS-MDRD GFR (r=0.534, B=-12.9, 95% CI -18.1 to -7.6, p<0.001 when adjusted for age and sex). Conclusion: Urine periostin/creatinine value at the time of initial diagnosis correlated with renal pathology and might predict the renal progression in patients with IgAN.
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