Dyslipidemia may be a risk factor for progression in children with IgA nephropathy

Zhuang, Hongkai; Lin, Zhilang; Zeng, Shuhan; Jiang, Mengjie; Chen, Lizhi; Jiang, Xiaoyun; Xu, Yong

doi:10.1007/s00467-022-05480-x

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…The above important studies also revealed that children with glomerular disease, particularly MCD, had infrequent monitoring for dyslipidemia and were less likely to be offered lipid-lowering treatment. 54 In addition, a recent study in children with IgA nephropathy showed that those with dyslipidemia may have a lower probability of renal survival, 56 highlighting the urgent need for diagnosis and management of these common sequelae associated with glomerular disease. In the Ashoor study, another important factor noted was that up to 14% of children with hypertension were not being treated, 54 thus contributing further to their CV disease risk burden.…”

Section: Glomerular Disease and CV Risk In Childrenmentioning

confidence: 99%

Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities

Myette,

Lamarche,

Odutayo

et al. 2024

Can J Kidney Health Dis

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Purpose of review: Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study. Sources of information: The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner. Methods: We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective. Key findings: Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective. Limitations: This is a narrative review and does not represent a comprehensive and systematic review of the literature.

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Section: Glomerular Disease and CV Risk In Childrenmentioning

confidence: 99%

Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities

Myette,

Lamarche,

Odutayo

et al. 2024

Can J Kidney Health Dis

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“…What do we already use to inform clinical decisions in IgAN? Uncontrolled hypertension, 10 , 11 older age, 12 obesity, and dyslipidemia 13 , 14 , 15 , 16 , 17 are clearly associated with poor prognosis; hypertension is an especially useful prognostic marker. Smoking and nicotine have multiple deleterious effects on the kidney and are associated with the progression of kidney disease.…”

Section: Evaluating Risk Of Progression In Igan: a Major Clinical Cha...mentioning

confidence: 99%

Evaluating Progression Risk in Patients With Immunoglobulin A Nephropathy

Cattran,

Floege,

Coppo

2023

Kidney International Reports

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Prognostic value of low-density lipoprotein cholesterol in IgA nephropathy and establishment of nomogram model

Tian

Li²,

Chu³

et al. 2023

Front. Endocrinol.

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BackgroundDyslipidemia is closely related to kidney disease. We aimed to investigate the relationship between low-density lipoprotein cholesterol (LDL-C) and prognosis of IgA nephropathy (IgAN) and build a nomogram prognostic model.Methods519 IgAN patients with 61 months median follow-up were enrolled and divided into two groups based on the cut-off value of baseline LDL-C (2.60 mmol/L): the high group (n=253) and the low group (n=266). Renal survival was assessed by Kaplan⁃Meier (KM) survival curve. Risk factors were identified by COX regression analysis. The area under the receiver operating characteristic (ROC) curves (AUC), concordance index (C-index), and calibration curves were applied to evaluate the nomogram model.ResultsKM survival curve analysis showed that the high LDL-C group had worse renal survival than the low LDL-C group (χ2 = 8.555, p=0.003). After adjusting for confounding factors, Cox regression analysis showed the baseline LDL-C level was an independent risk factor of end-stage renal disease (ESRD) in IgAN (HR=3.135, 95% CI 1.240~7.926, p =0.016). LDL-C, segmental sclerosis, tubular atrophy/interstitial fibrosis, the prevalence of cardiovascular disease, 24-hour proteinuria were identified and entered into the nomogram models, with AUC of 0.864, 0.827, and 0.792 respectively to predict the 5-, 8-, and 10-year risk of ESRD in IgAN. The C-index of this prediction model was respectively 0.862, 0.838, and 0.800 and was well-calibrated.ConclusionElevated LDL-C level is a predictive factor for the prognosis of IgAN. We developed a nomogram model that can predict the risk of ESRD in IgAN by using LDL-C ≥ 2.60 mmol/L.

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Dyslipidemia may be a risk factor for progression in children with IgA nephropathy

Cited by 3 publications

References 37 publications

Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities

Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities

Evaluating Progression Risk in Patients With Immunoglobulin A Nephropathy

Prognostic value of low-density lipoprotein cholesterol in IgA nephropathy and establishment of nomogram model

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