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Differences of clinicopathological characteristics and outcomes of IgA nephropathy patients with and without nephrotic syndrome

  • Nephrology - Original Paper
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Abstract

Purpose

To evaluate the differences in clinicopathological features and outcomes of IgA nephropathy (IgAN) patients with and without nephrotic syndrome.

Methods

In this retrospective cohort study, IgAN patients from January 2006 to December 2011 in the First Affiliated Hospital of Sun Yat-sen University were enrolled and followed up to Dec 31, 2013. Logistic and Cox regression were conducted to evaluate the associated factors of nephrotic syndrome (NS) and its relation with outcomes of creatinine doubling and progression to end-stage kidney disease (ESKD).

Results

A total of 1413 patients with IgAN were enrolled in this study, 57 (4.0%) of whom exhibited NS. Meanwhile, 13 (22.8%) of NS IgAN patients had minimal change disease (MCD). Logistic regression showed that more presence of hypertension, less glomerular sclerosis, less tubular atrophy/interstitial fibrosis, and lower density of IgA deposition in mesangial region were significantly associated with NS IgAN that were independent of age and gender. In addition, a total of 921 patients (890 with non-NS IgAN and 31 with NS IgAN) were followed up to Dec 31, 2013. After adjusting for age, sex, baseline estimated glomerular rate, hypertension and hemoglobin, no significant difference was observed in outcomes of serum creatinine doubling and ESKD between patients with or without NS IgAN.

Conclusions

Prevalence of NS IgAN patients was 4.0%, and 22.8% of them had MCD. Patients with NS IgAN had more severe clinical but less severe pathological features. However, outcomes of serum creatinine doubling and ESKD were not significantly different between patients with or without NS IgAN.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

We thank all my colleagues in Sun Yat-sen University for their excellent data collection. We thank Xueqing Yu and Qiongqiong Yang for their help in the data curation and instruction for the project, Wenfang Chen and Shicong Yang for their help with reviewing renal biopsies. All authors have approved to the submitted paper for publication.

Funding

This work was supported by grants from the Natural Science Foundation of Guangdong Province (2023A1515012477), National Natural Science Foundation of China (82200820), Guangzhou Science and Technology Project (202201011483), Key Laboratory of National Health Commission, and Key Laboratory of Nephrology, Guangdong Province, Guangzhou, China (2020B1212060028), and 5010 Clinical Program of Sun Yat-Sen University (No. 2017007) and National Key Research and Development Project of China (No. 2021YFC2501302). Natural Science Foundation of Guangdong Province,2023A1515012477,Qinghua Liu,National Natural Science Foundation of China,82200820,Naya Huang, Guangzhou Municipal Science and Technology Project,202201011483,Naya Huang, Key Laboratory of Nephrology, Guangdong Province,2020B1212060028,5010 Clinical Program of Sun Yat-Sen University,2017007,National Major Science and Technology Projects of China,2021YFC2501302,Wei Chen

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Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China

    Naya Huang, Jianbo Li, Zhen Ai, Lin Guo, Wei Chen & Qinghua Liu

  2. NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University）and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, 510080, China

    Naya Huang, Jianbo Li, Zhen Ai, Lin Guo, Wei Chen & Qinghua Liu

Authors
  1. Naya Huang
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  2. Jianbo Li
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  3. Zhen Ai
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  4. Lin Guo
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  5. Wei Chen
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  6. Qinghua Liu
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Contributions

Conceptualization: Qinghua Liu and Wei Chen; data curation: Naya Huang and Jianbo Li; formal analysis: Naya Huang and Lin Guo; funding acquisition: Qinghua Liu; investigation: Naya Huang; methodology:, Naya Huang; project administration: Qinghua Liu and Wei Chen; resources: Qinghua Liu and Wei Chen; software: Naya Huang and Jianbo Li; supervision: Qinghua Liu and Wei Chen; validation: Naya Huang; visualization: Naya Huang; writing original draft: Naya Huang, Jianbo Li, and Lin Guo; writing—review and editing: Naya Huang, Jianbo Li, Qinghua Liu, and Wei Chen.

Corresponding author

Correspondence to Qinghua Liu.

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Huang, N., Li, J., Ai, Z. et al. Differences of clinicopathological characteristics and outcomes of IgA nephropathy patients with and without nephrotic syndrome. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04040-6

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