The amount of the complex detection obtained by the above-mentioned method divided in the density of the urine protein, and the value of the complex for each amount of the urine

protein was calculated; the results are shown in Fig. 7. Thirty-one IgAN patient samples and 36 JPH203 research buy kidney disease patient samples (other than IgAN) were able to be distinguished clearly by comparing the value of the complex for each amount of urine protein. Fig. 7 Distribution chart of the value of measurements that detect the IgA–uromodulin complex in urine in ELISA for each amount of urine protein in other disease groups. A spindle was indicated as ratio to standard sample. Cut-off line is drawn by ROC analysis in Fig. 8. 67 samples were analyzed including 31 IgAN (before treatment), 4 inactive IgAN (after treatment), 8 Alport syndrome, ABT-888 in vitro 3 amyloidosis, 4 MPGN, 2 ANCA-related nephritis, 2 TBMD,

4 FGS, 2 lupus nephritis, 2 DMN, 4 MN, and Salubrinal 1 hypertensive nephrosclerosis Moreover, the ROC analysis of the samples from the 36 kidney disease patients (other than IgAN) and the 31 IgAN patients created the ROC curve shown in Fig. 8. The cut-off value calculated from the ROC curve was 0.130. Twenty-four samples from 31 IgAN patients were positive (77.4%) and 5 samples from 36 kidney disease patients (other than IgAN) were positive (13.9%) as shown in Table 5, and both were able to be distinguished clearly. Sensitivity at that time was 77.4%, specificity was 86.1%, and diagnosis efficiency was 82.1%. When the IgA–uromodulin negative samples C-X-C chemokine receptor type 7 (CXCR-7) were included, the sensitivity was 75.0% (24/32), the specificity

degree was 88.1% (37/42), and the diagnosis efficiency was 82.4% (61/74). Fig. 8 Result of the ROC analysis of the value of measurements that detect the IgA–uromodulin complex in urine by ELISA for each amount of urine protein on Fig. 7 Table 5 Positive rate of IgAN and other kidney diseases by ELISA for the IgA–uromodulin complex for each amount of urine protein in Fig. 7   IgAN before treatment Other kidney diseases Total number 31 36 Positive number 24 5 Positive rate 77.4% 13.9% In particular, four samples of inactive IgAN were judged to be negative and all eight samples of Alport syndrome, which is difficult to discriminate with IgAN by urinalysis, were judged to negative. These facts show this urinary marker to be very effective in a clinical diagnosis. Discussion In this study, it was clarified that IgAN can be identified with a diagnosis rate of approximately 80% by measuring the complex of uromodulin and IgA in urine, and calculating the density per amount of urine protein.