Objectives:The current study aimed at evaluating the predictive value of serum IgG and IgG/IgM ratio measured on admission for steroid-resistant response after eight weeks of treatment in pediatric patients with idiopathic nephrotic syndrome (NS). Methods: The current cross sectional study was conducted on 69 children, including 41 patients with idiopathic NS and 28 healthy subjects as controls. Serum IgA, IgG, and IgM levels were measured in all subjects using immunoturbidimetric method. Results: The median serum IgA, IgG, and IgM levels were 1.15, 2.23, and 1.7 g/L, respectively. Serum IgA and IgG levels in patients were lower than controls (P < 0.001). In addition, 46.3% of children had steroid-resistant nephrotic syndrome (SRNS). IgG had a positive predictive value for SRNS (area under the curve (AUC) = 0.923, P < 0.001). With the cutoff point of 2.04 g/L, this test had the sensitivity and specificity of 89.5% and 95.5%, respectively. The IgG/IgM ratio also had a positive predictive value for SRNS (AUC = 0.892, P < 0.001). With the cutoff point of 1.64 g/L, this test had the sensitivity of and specificity of 89.5% and 81.8%, respectively. Conclusions: Serum IgG level and IgG/IgM ratio can be considered as predictive markers for steroid resistance in children first diagnosed with idiopathic NS.
Background: Delayed graft function (DGF) and acute rejection (AR) are common complications in kidney transplant patients. Objectives: The study evaluated DGF and AR in highly sensitized patients and their effects on kidney function for six months post-transplantation. Methods: We enrolled 95 patients with kidney transplants from living donors who were divided into two groups. Group 1 included 47 highly sensitized patients with panel reactive antibody (PRA) < 20.0% and negative donor-specific antigen, and group 2 included 48 patients with negative PRA. All patients were followed for the state of DGF, AR, and kidney function for six months. Results: Group 1 showed a significantly higher proportion of DGF and AR than group 2 (27.7% versus 2.1%, P < 0.001 and 14.9% versus 2.1%, P = 0.031, respectively). The rates of positive PRA in DGF and AR patients were significantly higher than those in non-DGF and non-AR patients (92.9% versus 42.0%, P < 0.001 and 87.5% versus 46.0%, P = 0.031, respectively). Transplanted kidney function was significantly worse in patients with PRA and DGF and/or AR than in patients with negative PRA and non-DGF and non-AR only in the seventh-day post-transplantation. Conclusions: Kidney transplant in highly sensitized patients with positive PRA was related to the increased ratio of DGF and AR.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.