Project: Research project

Project Details


IgA nephropathy, the most common form of glomerulonephritis worldwide, is
characterized by a variable clinical course with progression to chronic
renal disease in 20-40% of patients. Dietary fish oil supplementation
significantly retarded the rate of renal function in a group of proteinuric
patients with IgA nephropathy in a recently completed clinical trial
conducted by the Mayo Nephrology Collaborative Study Group. Currently, it
is difficult to identify patients that would be most likely to benefit from
such therapy, because there are few clinicopathologic parameters that
provide prognostic information in an individual patient. Since
endocapillary proliferation and extracellular matrix deposition are
principal morphologic alterations in IgA nephropathy, we propose to
determine whether new methods to assess these parameters may provide
additional prognostic information and provide a basis for therapeutic
decisions in newly diagnosed patients. The role of glomerular and
interstitial proliferation in predicting outcome in IgA nephropathy will be
determined by immunostaining renal biopsies with MIB-1, which identifies an
antigen expressed in G1, S2, S, and M phase cells, but not in G0 cells.
Since TGFbeta is a dominant mediator of extracellular matrix production,
deposition of this cicatricial mediator in renal biopsy material will be
assessed by immunohistochemical staining. To clarify the role of collagen
I and collagen IV accumulation during the course of progressive IgA
nephropathy, deposition of these macromolecules will also be assessed by
immunohistochemical staining. Diagnostic renal biopsies obtained from 106
patients with IgA nephropathy, the study cohort of the recently completed
clinical trial, will be used to establish progression risk factors based
upon glomerular and interstitial proliferation indices and relative
expression of TGFbeta, collagen I, and collagen IV. Patients with IgA
nephropathy and high progression risk factors will be entered into a
prospective study to assess the effects of varying amounts of omega (n)-3)
highly unsaturated fatty acids administrated in fish oil concentrates on
renal function outcome.
Effective start/end date9/30/948/31/97


  • National Institute of Diabetes and Digestive and Kidney Diseases
  • National Institute of Diabetes and Digestive and Kidney Diseases
  • National Institute of Diabetes and Digestive and Kidney Diseases


  • Medicine(all)


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