Clinicopathological features and prognosis of IgA nephropathy with renal arteriolosclerosis
10.3760/cma.j.cn441217-20220621-00638
- VernacularTitle:伴肾小动脉硬化病变的IgA肾病的临床病理特点及预后
- Author:
Weiyi GUO
1
;
Xiuping AN
;
Lijun SUN
;
Hongrui DONG
;
Xiaoyi XU
;
Wenrong CHENG
;
Guoqin WANG
;
Nan YE
;
Zhirui ZHAO
;
Hong CHENG
Author Information
1. 首都医科大学附属北京安贞医院肾内科,北京 100029
- Keywords:
Glomerulonephritis,IgA;
Arteriolosclerosis;
Prognosis;
Clinicopathological features;
Component C3c
- From:
Chinese Journal of Nephrology
2023;39(3):209-214
- CountryChina
- Language:Chinese
-
Abstract:
The study was a retrospective study. The clinical data of 866 patients with IgA nephropathy (IgAN) in Beijing Anzhen Hospital, Capital Medical University from March 2010 to March 2021 were analyzed, to investigate the clinical pathology and renal prognosis of IgAN patients with intrarenal arteriolosclerosis, and to preliminarily explore whether abnormal activation of complement system is involved in the injury of arteriolosclerosis. The patients were divided into renal arteriolar lesions group and non-renal arteriolar lesions group according to the renal histopathology, and the differences of clinical pathological manifestations, prognosis between the two groups were compared. The results showed that, compared with the non-renal arteriolar lesions group ( n=236), IgAN patients in the renal arteriolar lesions group ( n=630) had higher proportions of hypertension and malignant hypertension, higher levels of urinary albumin-creatinine ratio, 24-hour urine protein quantification and serum uric acid, lower estimated glomerular filtration rate, and more severe MEST-C lesions of the Oxford classification (all P < 0.05). Cox regression analysis results showed that intrarenal arteriolosclerosis was the independent risk factor affecting the progression of IgAN to ESRD ( HR=6.437, 95% CI 2.013-20.585, P=0.002). Renal histopathology showed that the deposition of complement C3c on the wall of intrarenal arterioles in the renal arteriolar lesions group ( n=98) was stronger than that in non-renal arteriolar lesions group ( n=18, P < 0.05). IgAN patients with renal arteriolosclerosis present with serious clinical and pathological manifestations, and renal prognosis. Abnormal activation of complement system may be involved in the pathogenesis of intrarenal arteriolosclerosis.