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Background  Tumor necrosis factor alpha (TNF-α) is considered to play an important role in the pathogenesis in IgA nephropathy (IgAN). The correlations between serum TNF-α and disease severity in patients with IgAN remain controversial.    Methods  Concentrations of serum TNF-α of 147 patients with IgAN and 126 healthy subjects were measured by chemiluminescence immunoassay. Correlations with clinicopathological features of patients with IgAN were evaluated.    Results  Serum levels of TNF-α [9.20 (7.70–10.60) pg/mL vs. 6.04 (5.11–7.23) pg/mL,  P  &lt; 0.0001] were higher in patients with IgAN than that in healthy subjects. Receiver operating characteristic curve analysis revealed that TNF-α had better discrimination between patients with IgAN and healthy controls than estimated glomerular filtration rate [TNF-α: (AUC, 0.87; 95% CI, 0.83–0.91;  P  &lt; 0.0001) vs. estimated glomerular filtration rate: (AUC, 0.76; 95% CI, 0.71–0.82;  P  &lt; 0.0001),  P  = 0.007]. Multivariate linear regression analyses showed that serum levels of TNF-α were positively correlated with 24-h urine protein excretion ( r  = 0.33,  P  = 0.04), urinary protein to serum creatinine ratio ( r  = 0.33,  P  = 0.03), serum creatinine ( r  = 0.46,  P  &lt; 0.0001) and Cystatin C ( r  = 0.59,  P  &lt; 0.0001) in IgAN and negatively correlated with estimated glomerular filtration rate ( r  = − 0.49,  P  &lt; 0.0001) after adjustment for sex, systolic blood pressure and diastolic blood pressure. Patients with higher mesangial hypercellularity or tubular atrophy/interstitial fibrosis score according to Oxford classification showed higher serum levels of TNF-α.    Conclusions  Our data showed that serum levels of TNF-α detected by chemiluminescence immunoassay was a potential biomarker for evaluating the disease severity in IgAN.    Electronic supplementary material  The online version of this article (10.1186/s12882-018-1069-0) contains supplementary material, which is available to authorized users.

Serum levels of tumor necrosis factor alpha in patients with IgA nephropathy are closely associated with disease severity