Growth differentiation factor 15 as a predictor of adverse renal outcomes in patients with immunoglobulin A nephropathy

Intern Med J. 2017 Dec;47(12):1393-1399. doi: 10.1111/imj.13614.

Abstract

Background: Growth differentiation factor 15 (GDF 15) has recently been reported as a useful prognostic marker in patients with chronic inflammatory disease and heart disease.

Aim: To evaluate the role of GDF 15 as a potential prognostic predictor of renal outcome in immunoglobulin A nephropathy (IgAN).

Methods: In total, 212 patients in the Chungnam National Hospital glomerulonephritis cohort, who were diagnosed as biopsy-proven IgAN between March 2010 and June 2014, were included. GDF Fifteen was analysed by the enzyme-linked immunosorbent assay. Cut-off values of the GDF 15 and the hazard ratio of it resulting in haemodialysis within 2 years were analysed.

Results: The level of serum GDF 15 was negatively correlated with the initial eGFR. A serum GDF 15 level of more than 496.32 pg/mL showed 90% sensitivity and 72.9% specificity to predict the possibility of it resulting in haemodialysis within 2 years. In addition, a GDF 15 level higher than 490.4 pg/mL showed 63.64% sensitivity and 65% specificity to predict a decline in eGFR > 30 mL/min within 1 year of follow up. Moreover, initial serum GDF 15 level was associated with the development of interstitial fibrosis/tubular atrophy.

Conclusions: Initial serum GDF 15 level showed an inverse correlation with serum eGFR and was associated with worse renal outcome. Our results suggested that GDF 15 may play a role as a potential prognosticator in IgAN.

Keywords: GDF 15; IgA nephropathy; renal fibrosis; renal inflammation.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Glomerular Filtration Rate / physiology*
  • Glomerulonephritis, IGA / blood*
  • Glomerulonephritis, IGA / diagnosis*
  • Glomerulonephritis, IGA / physiopathology
  • Growth Differentiation Factor 15 / blood*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Single-Blind Method
  • Treatment Outcome

Substances

  • Biomarkers
  • GDF15 protein, human
  • Growth Differentiation Factor 15