Clinicopathological and prognostic analysis of children with primary IgA nephropathy with C1q deposition
10.3760/cma.j.issn.1001-7097.2019.09.003
- VernacularTitle: 伴C1q沉积的原发性IgA肾病患儿临床病理及预后分析
- Author:
Heyan WU
1
;
Xiaojie LI
2
;
Chunlin GAO
1
;
Zhengkun XIA
1
Author Information
1. Department of Pediatrics, Jinling Hospital, Southern Medical University, Nanjing 210002, China
2. Department of Pediatrics, Jinling Hospital, Nanjing University, Nanjing 210002, China
- Publication Type:Clinical Trail
- Keywords:
Glomerulonephritis, IgA;
Child;
Pathology, Clinical;
C1q deposition;
Prognosis
- From:
Chinese Journal of Nephrology
2019;35(9):655-661
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical and pathological features and prognosis of children with IgA nephropathy with C1q deposition.
Methods:The children with IgA nephropathy diagnosed by renal biopsy from January 1, 2000 to December 30, 2017 were retrospectively analyzed and divided into C1q deposit group and C1q negative group according to glomerular immunofluorescence examination. Follow-up until the patient's serum creatinine doubled, glomerular filtration rate decreased by more than 50%, entering end-stage kidney disease, renal replacement therapy or death. Kaplan-Meier survival analysis was used to evaluate the renal survival rate in two groups. Univariate and multivariate Cox proportional hazard regression models were used to analyze the effect of C1q deposition on the prognosis of patients with IgA nephropathy.
Results:There were 60 cases in C1q deposition group and 60 cases in C1q negative group. (1) the initial eGFR and plasma albumin in C1q deposition group were lower than those in C1q negative group, while the levels of serum creatinine, serum cholesterol and 24 hour urinary protein in C1q group were higher than those in C1q negative group (all P<0.05). (2) pathological indexes: Mesangial cell proliferation, tubular atrophy/interstitial fibrosis, and cell/fibrocytic crescein score in C1q negative group were significantly higher than those in C1q negative group (all P<0.0.5). (3) Kaplan-Meier analysis showed that there was significant difference in renal cumulative survival rate between the two groups (Log-rank test: χ2=6.801, P=0.009). Cox proportional hazard regression model showed that the risk of renal end-point events in IgAN children with C1q deposition group was 5.772 times higher than that in C1q negative group (HR=5.772, 95%CI: 1.353-24.6211, P=0.018).
Conclusion:C1q deposition is an independent risk factor for the progress of renal function in IgA nephropathy children.
