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.
Purpose: To evaluate serum adiponectin and leptin concentration in new-onset diabetes after transplantation (NODAT) and non-NODAT patients and association with renal function in kidney transplant recipients (KTRs).
Patients and methods: A study of 314 consecutive adults KTRs divided into four groups: 236 individuals without NODAT who had renal insufficiency (RI; n = 56) or normal renal function (n = 180) and 78 patients with NODAT who had RI (n = 17) or normal renal function (n = 61). NODAT was diagnosed based on venous fasting blood glucose or HbA1c with the criteria of the American Diabetes Association. Renal insufficiency was defined according to KDOQI 2002 guidelines.Results: In the NODAT group, the median level of serum adiponectin was lower than that of non-NODAT one (30 µg/ml vs 37.15 µg/ml, p < 0.001); in contrast, the median leptin concentration was higher (4.27 ng/ml vs 4.05 ng/ml, p = 0.024). In the RI group, both median serum adiponectin and leptin levels were higher than those of non-RI one (Adiponectin: 40.01 µg/ml vs 33.7 µg/ml; Leptin: 4.51 ng/ml vs 3.91 ng/ ml, p < 0.001 both). We found that BMI was related to both adiponectin and leptin levels in both NODAT, non-NODAT, and all subject groups, based on univariate and multivariate linear regression analysis.
Conclusion:New-onset diabetes after transplantation, BMI, and renal insufficiency were affected to the serum level of adiponectin and leptin in KTRs.
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