IgA Nephropathy in Czech Patients - Are We Able Reliably Predict the Outcome?

Maixnerová, Dita; Neprašová, Michaela; Skibová, J; Mokrišová, Jana; Ryšavá, R; Reiterová, Jana; Jančová, Eva; Merta, M; Zadrazil, J; Honsová, Eva; Tesař, Vladimı́r

doi:10.1159/000368467

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…An additional, though already previously known finding of our study is confirmation of an adverse effect of male gender and reduced GFR at baseline on long-term renal outcomes [ 8 , 9 , 10 , 11 ].…”

Section: Discussionsupporting

confidence: 74%

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The Role of Complement Component C3 Activation in the Clinical Presentation and Prognosis of IgA Nephropathy—A National Study in Children

Mizerska-Wasiak

Such-Gruchot

Cichoń-Kawa

et al. 2021

JCM

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The aim of the study was to evaluate the influence of the intensity of mesangial C3 deposits in kidney biopsy and the serum C3 level on the clinical course and outcomes of IgAN in children. The study included 148 children from the Polish Pediatric IgAN Registry, diagnosed based on kidney biopsy. Proteinuria, creatinine, IgA, C3 were evaluated twice in the study group, at baseline and the end of follow-up. Kidney biopsy was categorized using the Oxford classification, with a calculation of the MEST-C score. The intensity of IgA and C3 deposits were rated from 0 to +4 in immunofluorescence microscopy. The intensity of mesangial C3 > +1 deposits in kidney biopsy has an effect on renal survival with normal GFR in children with IgAN. A reduced serum C3 level has not been a prognostic factor in children but perhaps this finding should be confirmed in a larger group of children.

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Section: Discussionsupporting

confidence: 74%

“…Proteinuria, reduction of the glomerular filtration rate (GFR), hypertension, old age, male sex and the absence of macroscopic hematuria are independent predictors of a poor outcome of the disease [ 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Complement Component C3 Activation in the Clinical Presentation and Prognosis of IgA Nephropathy—A National Study in Children

Mizerska-Wasiak

Such-Gruchot

Cichoń-Kawa

et al. 2021

JCM

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“…Theories above could provide our result with support that serum UA and Hb levels during the follow-up can significantly affect the progress of IgAN to ESRD. Although TA-P was excluded from the final multivariate analysis for the accuracy of the mode, the importance of it cannot simply be ignored (Additional file 1, mode 15) and it had also long been recognized as a strong and reliable factor to renal outcome [16, 17]. …”

Section: Discussionmentioning

confidence: 99%

Risk factors of progressive IgA nephropathy which progress to end stage renal disease within ten years: a case–control study

Shu

Zhang

et al. 2017

BMC Nephrol

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BackgroundThere were few related studies aiming to severe IgA nephropathy (IgAN) which could progress rapidly to end stage renal disease (ESRD) within ten years. To find valuable clinical or pathological factors and promising precautions is essential.MethodsA single center case–control study was performed. Fifty ESRD patients with the primary cause of IgAN and a short renal survival time of less than ten years after diagnose were enrolled in the case group. One hundred IgAN patients with a renal survival time of more than ten years were enrolled in the control group. IgA Oxford classification scores, clinical data at baseline and during the follow-up were collected. Multivariate logistic regression was used to investigate factors associated with the development of ESRD.ResultsThere were significant differences in baseline clinical data between these two groups, as well as the constituent ratio of Oxford MEST-score. Distinct differences were observed in time-average uric acid(TA-UA), time-average hemoglobin(TA-Hb), time-average albumin(TA-Alb), time-average total cholesterol(TA-TC) and time-average urinary protein(TA-P) during the follow-up. In multivariate logistic models, IgA Oxford score M1(OR = 5.10, P = 0.018) and eGFR(OR = 0.97, P = 0.039) at biopsy, TA-UA (OR = 2.06, P = 0.026) and TA-Hb (OR = 0.53, P = 0.022) during the follow-up were identified independent factors for developing ESRD.ConclusionIgAN patients with pathological assessment of M1, low baseline eGFR, TA-Hb and high TA-UA were more likely to progress to ESRD, and should be paid more attention. Appropriate regulations of UA, Hb and urine protein after diagnose may be a promising treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0429-x) contains supplementary material, which is available to authorized users.

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“…Several studies have been performed to evaluate the risk factors for progression of renal insufficiency in IgAN. Hypertension, elevated serum creatinine concentration, proteinuria, old age, male sex and the absence of macroscopic hematuria have been found to be independent predictors of an unfavorable outcome [4][5][6][7]. Hyperuricemia and a number of proteins related to the complement system also emerged as independent risk factors for progression of IgAN [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

The Clinical Significance of Uric Acid and Complement Activation in the Progression of IgA Nephropathy

Çalışkan¹,

Celik²,

Öztop

et al. 2016

Kidney Blood Press Res

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Background/Aims: The aim of this study is to investigate the utility of clinical [age, gender, mean arterial pressure (MAP)] and laboratory parameters [eGFR, hemoglobin (Hgb), serum levels of creatinine, uric acid, albumin, proteinuria, hematuria] and also histopathological lesions (Oxford classification parameters, crescents, intensity and pattern of staining for C3, C1Q, IgA, IgG, IgM) as progression markers in patients with IgA Nephropathy (IgAN). Methods: A total of 111 IgAN patients with a follow-up period >1 year or who reached kidney failure [GFR category G5 chronic kidney disease (CKD)] <1 year were investigated. Primary endpoint was the development of kidney failure or eGFR decline ≥50% from the baseline. Kaplan-Meier and Cox proportional hazards analyses were performed. Results: Mean follow-up period was 33±29 months. Thirty-seven (33.3%) patients progressed to kidney failure and 4 (3.6%) patients developed eGFR decline ≥50% from the baseline after a median of 23 and 65 months, respectively. In multivariate Cox regression analysis, baseline levels of Hgb (HR:0.782, 95% CI 0.559-0.973, p=0.037), serum uric acid (HR:1.293, 95% CI 1.023-1.621, p=0.046), eGFR (HR:0.966, 95% CI 0.947-0.984, p=0.004) and intensity of C3 staining (HR:1.550, 95% CI 1.198-1.976, p=0.049) predicted primary endpoint. Serum uric acid level was associated independently with T score (β=0.303, p=0.005) in patients with eGFR>30 ml/min/m². Conclusions: Hyperuricemia and the deposition of C3 are independent risk factors for IgAN progression.

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IgA Nephropathy in Czech Patients - Are We Able Reliably Predict the Outcome?

Cited by 9 publications

References 21 publications

The Role of Complement Component C3 Activation in the Clinical Presentation and Prognosis of IgA Nephropathy—A National Study in Children

The Role of Complement Component C3 Activation in the Clinical Presentation and Prognosis of IgA Nephropathy—A National Study in Children

Risk factors of progressive IgA nephropathy which progress to end stage renal disease within ten years: a case–control study

The Clinical Significance of Uric Acid and Complement Activation in the Progression of IgA Nephropathy

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