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Journal of Nephrology

Erschienen in:

05.08.2023 | original Article

Clinical significance of IgM and C3 deposition in children with primary immunoglobulin A nephropathy

verfasst von: Limei Xiong, Lili Liu, Yuhong Tao, Hui Guo

Erschienen in: Journal of Nephrology | Ausgabe 8/2023

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Abstract

Background

Mesangial IgM and C3 deposition is commonly observed in patients with primary immunoglobulin A nephropathy (IgAN), but its characteristics and prognosis have rarely been reported. The aim of this study was to investigate the relationship between combined mesangial IgM and C3 deposition and disease progression in children with IgAN.

Methods

One hundred sixteen children diagnosed with IgAN between 2016 and 2020 were selected. Renal biopsies were scored by Oxford classification including the presence of mesangial hypercellularity, endocapillary hypercellularity, segmental glomerulosclerosis, tubular atrophy/interstitial fibrosis and crescents. The primary renal outcome was an event of either ≥ 50% reduction of eGFR from the baseline value or the onset of end-stage renal disease within the follow-up period. Cox regression analysis was performed to examine the effect of the combined mesangial IgM and C3 deposition on renal outcomes.

Results

Forty-seven (40.52%) patients presented combined mesangial IgM and C3 deposition. Compared with children without combined IgM and C3 deposition, children with combined IgM and C3 deposition presented higher mesangial hypercellularity, endocapillary hypercellularity and cresentic lesions in kidney biopsies, and higher prevalence of renal dysfunction (19.15% versus 2.90%; P = 0.007). Renal outcome was also significantly worse as revealed by Kaplan–Meier curves (P = 0.0034). Multivariable Cox analysis identified tubular atrophy/interstitial fibrosis lesions [hazard ratio (HR) 14.843, 95% CI, 3.497–62.997, P < 0.001] and intensity of IgM deposition (HR 2.838, 95% CI, 1.321–6.094, P = 0.007) as independent risk factors for poor renal function.

Conclusions

Combined mesangial IgM and C3 deposition was associated with unfavorable histopathological features. Mesangial IgM deposition was an independent risk factor for poor renal outcomes in children with primary IgAN.

Graphical abstract

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Titel: Clinical significance of IgM and C3 deposition in children with primary immunoglobulin A nephropathy
verfasst von: Limei Xiong
Lili Liu
Yuhong Tao
Hui Guo
Publikationsdatum: 05.08.2023
Verlag: Springer International Publishing
Erschienen in: Journal of Nephrology / Ausgabe 8/2023
Print ISSN: 1121-8428
Elektronische ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-023-01724-7

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Springer Medizin

Clinical significance of IgM and C3 deposition in children with primary immunoglobulin A nephropathy

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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