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5. Combined Effects of the Serum IgA/C3 Ratio and Glomerular C3 Staining on the Renal Outcome in Adult Immunoglobulin A Nephropathy.

Author

Yang, Dandan, Pei, Gaiqin, Wang, Siqing, Qin, Aiya, Tang, Yi, and Qin, Wei

Subjects
IGA glomerulonephritis, SEX factors in disease, ADULTS, RENAL biopsy, KIDNEY glomerulus diseases, FOCAL segmental glomerulosclerosis, PROGNOSTIC models
Abstract

Introduction: The aim of this study was to evaluate the predictive value of the serum IgA/C3 ratio and glomerular C3 deposits in kidney biopsy in adult IgA nephropathy. Methods: The study included 718 adult IgAN patients diagnosed based on kidney biopsy. Patients without corticosteroids or immunosuppressive drugs >1 month were regularly followed up for at least 1 year or until the study endpoint. The optimum serum IgA/C3 ratio was calculated by the AUROC-based cutoff ratio. Proteinuria, creatinine, eGFR, serum IgA, and serum C3 were evaluated at baseline. Kidney biopsy was categorized using the Oxford classification, with a calculation of the MEST-C score. The degree of glomerular C3 staining was semiquantitatively determined (grade 0, no or trace; grade 1, mild; grade 2, moderate; grade 3, marked) by immunofluorescence microscopy. The patients were divided into four groups by the serum IgA/C3 ratio and glomerular C3 staining. Results: The baseline data suggested that when the serum IgA/C3 ratio was at the same level, patients with a high glomerular C3 staining score (≥2) always had mesangial proliferation, segmental glomerulosclerosis, and tubular atrophy/interstitial fibrosis (group 1 vs. group 2; group 3 vs. group 4). When glomerular C3 staining was at the same level, proteinuria was significantly higher in patients with serum IgA/C3<2.806 (group 1 vs. group 3; group 2 vs. group 4), which was contrary to previous studies that have suggested that the serum level of IgA/C3 was associated with disease severity. Hence, this study set out to investigate the combined effects of the serum IgA/C3 ratio and glomerular C3 staining on the renal outcome in adult IgA nephropathy. Renal survival analysis indicated that serum IgA/C3 ≥2.806 and glomerular C3 staining ≥2 (group 1) may be correlated with a poorer prognosis, especially in different clinicopathological characteristics of IgAN patients based on the subgroup analysis. Multivariate Cox analysis demonstrated that hypertension, serum creatinine, CKD stage, T1/2 and C3 staining were independent predictive factors of renal survival. Conclusions: The combination of serum IgA/C3 and C3 staining may contribute to improved optimization of the prognostic model in IgAN patients, especially patients with different sexes and degrees of disease. However, further study is required for validation in the future. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Additional file 1 of Probiotics ameliorate IgA nephropathy by improving gut dysbiosis and blunting NLRP3 signaling

Author

Tan, Jiaxing, Dong, Lingqiu, Jiang, Zheng, Tan, Li, Luo, Xinyao, Pei, Gaiqin, Qin, Aiya, Zhong, Zhengxia, Liu, Xiang, Tang, Yi, and Qin, Wei

Abstract

Additional file 1: Table S1. The inclusion and exclusion criteria of the clinical study. Table S2. The primer sequence of this study. Figure S1. PAS staining and statistical results of wild-type normal controls (WC group), wild-type mice with IgAN (W-IgAN group), W-IgAN treated with probiotics (W-IgAN+B group), NLRP3-/- mice (NC), NLRP3-/- mice with IgAN (N-IgAN), and N-IgAN treated with probiotics (N-IgAN+B). Figure S2. PAS staining and statistical results of wild-type normal controls (WC group), wild-type mice with IgAN (W-IgAN group), W-IgAN treated with probiotics (W-IgAN+B group), W-IgAN treated with sodium acetate (W-IgAN+SA group) and W-IgAN treated with sodium propionate (W-IgAN+SP group)

Published
2022
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16. Arterial-Arteriolar Sclerosis Is Independently Associated With Poor Renal Outcome in IgA Nephropathy Patients

Author

Dong, Lingqiu, Tan, Jiaxing, Li, Fangming, Wang, Siqing, Jiang, Zheng, Qin, Aiya, Zhong, Zhengxia, Zhou, Xiaoyuan, Tang, Yi, and Qin, Wei

Subjects
end-stage renal disease, renal survival, arterial-arteriolar sclerosis, Medicine, IgA nephropathy, urologic and male genital diseases, chronic kidney disease, Original Research
Abstract

Aim: This study aimed to investigate the clinicopathological features and prognosis of immunoglobulin A nephropathy (IgAN) with arterial-arteriolar sclerosis (AS). Methods: Patients with biopsy-proven IgAN from the West China Hospital of Sichuan University were retrospectively enrolled. Clinicopathological features were collected. Patients were categorized based on the presence and the severity of the AS. All the patients were regularly followed-up until a composite end point. The correlation between AS and prognosis of IgAN was assessed. Results: A total of 1,424 patients were recruited and followed for 60.0 ± 28.7 months. Patients with AS tended to have older age, higher blood pressure, heavier proteinuria, higher serum creatinine, uric acid, and total triglyceride (TG). Meanwhile, they were more likely to have a lower estimated glomerular filtration rate (eGFR), hemoglobin, and albumin. At the end of follow-up, 126 patients in the AS group and 47 patients in the non-AS group had reached the composite end point (p < 0.001). AS was associated with the renal outcome (log-rank p < 0.001) and was an independent risk factor for the progression of IgAN (p = 0.049). The severity of AS was associated with renal outcomes (log-rank p < 0.001) and there was a trend that it might serve as an independent risk marker for progression of IgAN. In the subgroup analysis, patients presenting with AS and lower eGFR, albumin, and hemoglobin or higher proteinuria, uric acid, and TG had a significant trend for a shorter time to reach the end point (log-rank p < 0.001). Conclusion: AS was commonly seen in patients with IgAN and was independently associated with the poor prognosis.

Published
2021

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