Potential Association of Body Constitution with the Prognosis of IgA Nephropathy: A Long-Time Follow-Up of 203 Cases in China

Abstract

Objective. This study investigated the association between body constitution (BC) and the prognosis of IgA nephropathy. Methods. We analyzed 203 biopsy-diagnosed IgA nephropathy patients, who were followed up for (63.9±16.2) months. The participants’ BC statuses were evaluated with the Constitution in Chinese Medicine Questionnaire; the relationships between clinical parameters and renal outcomes were analyzed by Cox regression. Results. Patients were classified into chronic kidney disease stages with 43.4% in stage 1, 27.1% in stage 2, 26.1% in stage 3, 3.5% in stage 4, and none in stage 5. Qi-deficiency BC type was the most common BC type in IgA nephropathy patients. In univariate analysis, proteinuria of more than 1g/d, hypertension, renal impairment (estimated glomerular filtration rate <60 mL/min), hypoproteinemia, hyperuricemia, Yang-deficiency BC, and blood-stasis BC were associated with poor prognosis. Multivariate analysis identified that hypertension (hazard ratios (HR) 3.5, P=0.009), renal impairment (HR 5.8, P<0.001), Yang-deficiency BC (HR 2.3, P=0.041), and blood-stasis BC (HR 2.5, P=0.017) were independent predictors of unfavorable renal outcomes. Conclusions. Most patients of IgA nephropathy were biopsied at an early stage. Yang-deficiency BC and blood-stasis BC at biopsy were most closely associated with the worse prognosis of IgA nephropathy along with hypertension and renal impairment.

Association of Traditional Chinese Medicine Body Constitution and Health-Related Quality of Life in Female Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study

“…Previous studies have investigated the association of TCM body constitution with various diseases and conditions, such as coronary artery disease [4], type 2 diabetes [5], metabolic syndrome [5], IgA nephropathy [6], obesity [7], and cancer-related fatigue [8]. In addition, a recent review study based on five electronic literature databases, in both English and Chinese, identified 1639 clinical studies that evaluated the association between TCM body constitutions and various diseases.…”

Traditional Chinese medicine in treating IgA nephropathy: from basic science to clinical research

“…[13][14][16][17][18] With the damaged degree of pathological damage in IgAN patients increases gradually, TCM syndrome manifests changes from deficiency qi and yin to deficiency yin of liver and kidney, and then deficiency yang of spleen and kidney. [19][20][21] Besides, the stasis syndrome and rheumatism syndrome are significant comorbidities in the process of IgAN chronic progression. [18] The characteristics of TCM treatment for IgAN are mainly composed of tonic deficiency medicines, supplemented by blood-activating and stasis-eliminating medicines, heat-clearing medicines, inducing diuresis and excreting dampness medicines, and astringent medicines to combine with formulas.…”

“…[19] Many studies used Lee's grading system and Katafuchi score system to classify the severity of glomerulus and tubulointerstitial lesions of IgAN and then to investigate the relationship between renal pathological classifications and TCM syndromes. [20][21] It is reported that the pathological change of IgAN patients with the spleen and kidney yang deficiency syndrome was the most serious, and follow by the liver and kidney yin deficiency syndrome. [22] For IgAN patients with Lee's grade above, conventional treatment is nourishing yin of liver and kidney or nourishing yang of spleen and kidney.…”

Huangkui Capsule in Combination with Leflunomide Improves Immunoglobulin A Nephropathy by Inhibiting the TGF-β1/Smad3 Signaling Pathway

“…Primary immunoglobulin A nephropathy (IgAN) is one of the most common glomerular diseases in children and teenagers and is mainly characterized by proteinuria, filtration membrane injury, and glomerulonephritis (1,2). In China, the development of IgAN is the major cause of end-stage kidney diseases (3)(4)(5). Delayed or inappropriate treatment of patients with IgAN in the early stage resulted in permanent disability in approximately 30% of these patients (4,6).…”

“…In China, the development of IgAN is the major cause of end-stage kidney diseases (3)(4)(5). Delayed or inappropriate treatment of patients with IgAN in the early stage resulted in permanent disability in approximately 30% of these patients (4,6).…”