First‐year GFR slope and long‐term renal outcome in IgA nephropathy

Lee, Kyung-Ho; Shin, Jungho; Park, Jeeeun; Hwang, Subin; Jang, Hye Ryoun; Huh, Wooseong; Kwon, Ghee Young; Kim, Yoon-Goo; Oh, Ha Young; Lee, Jung Eun; Kim, Dae Joong

doi:10.1111/eci.12936

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Whilst the more rapid decliners were more likely to require RRT, this did not translate into increased mortality. A previous study calculated eGFR slopes for the first-year post diagnosis of IgAN, and suggested that rapid and slow decliners over this period had significantly increased risk of progression compared to non-decliners (relative risk 8.8 and 10.2 respectively) [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

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The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience

et al. 2022

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Background and objectives IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, with an incidence of 2.5 per 100,000 population per year. The 10-year risk of progression to end stage kidney disease (ESKD) or halving of eGFR is 26%. Here we aimed to collect a comprehensive dataset of IgAN patients at our centre over 2 decades to provide real world data, describe outcomes and determine the effects of immunosuppression use. Design, setting, participants and measurements All patients diagnosed with biopsy-proven IgAN at our centre over 2 decades were identified. After exclusions, the total cohort size was 401. Data relating to (i) baseline demographics, (ii) laboratory and urine results, (iii) histological data, and (iv) outcomes of initiation of renal replacement therapy (RRT) and mortality were collected. Results The median age was 45.0 years, with 69.6% male and 57.6% hypertensive; 20.4% received immunosuppression, 29.7% progressed to RRT and 19.7% died, over a median follow up period of 51 months. Baseline eGFR was 46.7ml/min/1.73m2 and baseline uPCR was 183mg/mmol. Median rate of eGFR decline was -1.31ml/min/1.73m2/year. Those with a higher MEST-C score had worse outcomes. Immunosuppression use was associated with an increased rate of improvement in proteinuria, but not with a reduction in RRT or mortality. Factors favouring improved outcomes with immunosuppression use included female gender; lower age, blood pressure and T-score; higher eGFR; and ACEi/ARB use. Conclusions A variety of clinical and histological factors are important in determining risk of progression in IgAN. Therapeutic interventions, particularly use of immunosuppression, should be individualised and guided by these factors.

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Section: Discussionmentioning

confidence: 99%

“…increased risk of progression compared to non-decliners (relative risk 8.8 and 10.2 respectively) [15].…”

Section: Plos Onementioning

confidence: 99%

The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience

et al. 2022

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“…iga nephropathy is the most important factor that leads to end-stage kidney disease progression (1). it is well known that iga nephropathy is a progressive disease.…”

Section: Introductionmentioning

confidence: 99%

BAFF is involved in the pathogenesis of IgA nephropathy by activating the TRAF6/NF‑κB signaling pathway in glomerular mesangial cells

Cao

Chen

et al. 2019

Mol Med Report

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The aim of the present study was to investigate the involvement of B cell-activating factor (BaFF) in the pathogenesis of iga nephropathy by activating the tumor necrosis factor receptor-associated factor 6 (TraF6)/nF-κB signaling pathway in glomerular mesangial cells. For the clinical analysis, blood, urine and kidney tissue samples were collected from 58 patients diagnosed with primary iga nephropathy by renal biopsy. For the in vitro study, glomerular mesangial cells were divided into five groups: Control (con)-short hairpin rna (shrna) (control group); con-shrna + BaFF (20 ng/ml); con-shrna + BaFF + BaFF-rFc chimera protein (500 µg/ml); TraF6-shrna; and TraF6-shrna + BaFF (20 ng/ml). For the in vivo experiments, 60 Sprague-dawley rats were randomly divided into four groups: con-small interfering rna (sirna) (control group); con-sirna + iga (iga nephropathy group), BaFF-rFc chimera protein (2 µg/ml) + iga, and TraF6-sirna (0.2 µM) + iga. reverse transcription-quantitative Pcr was performed to evaluate the mrna expression levels of TraF6, connective tissue growth factor (cTGF), fibronectin (Fn) and nF-κBP65. Western blot analysis was used to detect the protein expression levels of TraF6, Fn, cTGF and phosphorylated-nF-κBP65 in glomerular mesangial cells and kidney tissues. The results revealed that plasma BaFF levels were positively correlated with the severity of pathological damage in patients with iga nephropathy. In vitro, BaFF induced the mrna and protein expression of TraF6, cTGF, Fn and nF-κBP65 in glomerular mesangial cells. after the BaFF-rFc chimera protein was added to inhibit the binding of BaFF and BaFF-receptor (-r), this effect was reduced. In vivo, inhibition of the effects of BaFF via injection with the BaFF-r Fc chimera protein reduced kidney damage in rats suffering from iga nephropathy. The effect on the expression of signaling pathway-associated proteins was also alleviated. in conclusion, BaFF enhanced the expression of fibroblast factors in the kidneys by activating the TraF6/nF-κB signaling pathway.

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The association of normal-range serum phosphorus with immunoglobulin A nephropathy progression: a retrospective cohort study

Ding

Yang

et al. 2023

Int Urol Nephrol

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First‐year GFR slope and long‐term renal outcome in IgA nephropathy

Abstract: First-year GFR slope was associated with increased risk of renal progression, independent of proteinuria and histologic findings. Further studies are needed to investigate whether early GFR change can identify high-risk patients who benefit from immunosuppressive treatment in IgAN.

Cited by 3 publications

References 29 publications

The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience

The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience

BAFF is involved in the pathogenesis of IgA nephropathy by activating the TRAF6/NF‑κB signaling pathway in glomerular mesangial cells

The association of normal-range serum phosphorus with immunoglobulin A nephropathy progression: a retrospective cohort study

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