However, in patients with more than 1.10 g/day of urinary protein, the CR rate of the Target Selective Inhibitor Library clinical trial subgroup with less than

buy Tipifarnib 6 years was 43 % (CR vs. non-CR, 23 vs. 54), compared to 23 % for the subgroup with more than 6 years (CR vs. non-CR, 11 vs. 48; P = 0.01). The CR rate according to the age at diagnosis and urinary protein level Figure 5 shows that the CR rate was 73 % (CR vs. non-CR; 88 vs. 35) in patients with between 0.3 and 1.09 g/day of urinary protein who were more than 20 years old at diagnosis. However, relatively low CR rates of 52.8 and 42.2 % were found in patients <19 years old and between 40 and 49 years old, respectively. There was no relationship between the number of years from diagnosis until TSP and pathological grade or eGFR, respectively (data not shown). Discussion This study revealed three major points. The first is that heat maps, based on eGFR and urinary protein, or pathological grade and urinary protein, can predict the CR rate at 1 year after TSP therapy in patients with IgA nephropathy. The second is that urinary protein is an important factor

influencing the CR rate among the variables studied, which also included grade of hematuria, pathological grade, number of years from diagnosis until TSP, and age at diagnosis. The third is that patients with proteinuria alone (without hematuria) or hematuria alone (<0.29 g/day of urinary protein) have relatively low CR rates of 28.5 and 60.8 %, respectively. Heat maps are useful tools for physicians Dimethyl sulfoxide to predict the CR rate in individual patients and DNA-PK inhibitor to explain the predicted CR rate to patients and their families. The highest CR rate was 82.5 % in patients with pathological grade I or II disease and <1.09 g/day of urinary protein, and approximately 70 % in patients with eGFR >30 ml/min/1.73 m2 and <1.09 g/day of urinary protein. These subgroups are good candidates for TSP. On the other hand, a poor CR rate of approximately 30 % was observed in patients with more than 1.5 g/day

of urinary protein regardless of eGFR. A randomized controlled trial comparing TSP, steroid pulse therapy, and antiplatelet drugs is needed to clarify the best treatment for IgA nephropathy patients with <1.09 g/day of urinary protein, because observations on long-term outcomes of IgA nephropathy with minimal or no proteinuria have revealed that 37.5 % of patients reach CR after a median of 48 months [5]. Recently, Ieiri et al. [6] emphasized that a shorter duration from diagnosis until TSP is associated with a high likelihood of CR in IgA nephropathy patients treated with TSP. In our previous study, the comparison between patients who reached CR and those who did not reach CR revealed significant differences in the number of years from diagnosis until TSP (P = 0.02), daily proteinuria (P < 0.0001), serum creatinine (P = 0.006), and pathological grade (P = 0.0006).