Utility of Serum Galactose Deficient for Ig A nephropathy: Prospective study from A Tertiary care center in South India"

This is a single center, prospective, observational study to to assess utility of galactose deficient IgA1 as a diagnostic marker for IgA nephropathy and to correlate the levels of galactose deficient IgA1 with severity of progression. We will be recruiting 50 patients ( age 2-80 years) with biopsy proven Ig A nephropathy not yet initiated on any immunosuppressive therapy. Demographic, clinical and laboratory (Including but not limited to serum creatinine, serum albumin and serum cholesterol and urinary protein creatinine ratio) will be recorded. Estimated glomerular filtration rate(eGFR) will be calculated using the 4 variable Modification of Diet in Renal Disease (MDRD) formula or CKD- EPI formula  for adults and the revised Schwartz formula for those who were <18 years of age. Renal biopsy(LM,IF and EM) findings will be noted. Gd-IgA1 level in serum will be measured by solid phase sandwich enzyme immunoassay kit (IBL international GmBH, Germany) following the manufacturer’s instructions. Patients will be initiated on guideline based therapy and followed up with investigations once in 3-4 months for a period of  24 months.  Similarly, controls will be taken from non Ig A gloemerular diseases such as memebranous nephropthay and FSGS. Study end points are  defined as 1.   more than 50 % fall from initial eGFR 2. ESRD – either estimated creatinine clearance <15 ml/mt or initiation of renal replacement therapy(RRT) and 3. death