机构:[a]Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China广东省中医院[b]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China大德路总院肾内科大德路总院肾内科广东省中医院[c]Department of Nephrology, Zhuhai Hospital of Guangdong Provincial Hospital of Chinese Medicine, Zhuhai, China大德路总院珠海院区肾内科大德路总院肾内科广东省中医院[d]Department of Hemodialysis, Guangzhou Charity Hospital, Guangzhou, China[e]Department of Hemodialysis, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China广东省中医院[f]Department of Pathology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China大德路总院珠海院区病理科病理科大德路总院病理科广东省中医院
Introduction: A working group on the Oxford classification of IgA nephropathy (IgAN) recently reported that crescents detected in the kidney tissue predicted a worse renal outcome. However, the effect of C1 lesion (crescents in <1/4th of all glomeruli) and their volume on the prognosis of IgAN is still unclear. We explored the association of C1 lesion with the renal prognosis in IgAN patients without obvious chronic renal lesions (glomerulosclerosis <25%, T score <2). Methods: We investigated 305 biopsy-proven IgAN patients without obvious chronic renal lesions. Clinicopathologic features and treatment modalities were recorded. The patients were divided into several groups according to the presence or absence of a global crescent: no crescent (NC) group, only segmental crescent (SC) group, and global crescent (GC) group. The outcome was the survival from a combined event defined by a >= 15% decline in the estimated glomerular filtration rate (eGFR) after 1 year or >= 30% decline in the eGFR after 2 years. Results: Among all patients, 75.7% were in the NC group, 14.8% were in the SC group, and 9.5% were in the GC group. Compared with the NC group, patients in the SC group and the GC group had more urine protein, lower eGFR, and presented with more severe pathological change. During a median follow-up of 34.8 (26.16-57.95) months, the combined event occurred in 34 individuals (11.1%). In a multivariate model, the GC group (HR = 2.756, 95% CI = 1.068-7.109) was associated with an increased risk of the combined event. Conclusions: In IgAN patients without obvious chronic renal lesions, the GC group had more severe clinical and pathological manifestations than in the NC group. GC is an independent risk factor for the progression of IgAN renal function.
基金:
The study was funded by the Research Project for Practice Development
of National TCM Clinical Research Bases (Project No.
JDZX2015202).
第一作者机构:[a]Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China[b]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
共同第一作者:
通讯作者:
通讯机构:[a]Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China[b]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
推荐引用方式(GB/T 7714):
Zaoqiang Lin,Lichang Liu,Rongling Zhang,et al.Volume of Crescents Affects Prognosis of IgA Nephropathy in Patients without Obvious Chronic Renal Pathology[J].AMERICAN JOURNAL OF NEPHROLOGY.2021,doi:10.1159/000516187.
APA:
Zaoqiang Lin,Lichang Liu,Rongling Zhang,Xuefei Lin,Fuhua Lu...&Chuan Zou.(2021).Volume of Crescents Affects Prognosis of IgA Nephropathy in Patients without Obvious Chronic Renal Pathology.AMERICAN JOURNAL OF NEPHROLOGY,,
MLA:
Zaoqiang Lin,et al."Volume of Crescents Affects Prognosis of IgA Nephropathy in Patients without Obvious Chronic Renal Pathology".AMERICAN JOURNAL OF NEPHROLOGY .(2021)