Clinical significance of mesangial IgM deposition in patients with IgA nephropathy
| Autor: | Sulen Sarioglu, Taner Camsari, Hayri Ustun Arda, Serkan Yildiz, Mehtat Unlu, Cihan Heybeli, Ali Çelik, Mehmet Asi Oktan, Caner Çavdar, Aykut Sifil |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Physiology 030232 urology & nephrology 030204 cardiovascular system & hematology urologic and male genital diseases Gastroenterology Nephropathy End stage renal disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Physiology (medical) Internal medicine medicine Humans Clinical significance Proportional Hazards Models Creatinine Proteinuria biology Proportional hazards model business.industry Glomerulonephritis IGA Middle Aged medicine.disease Glomerular Mesangium Immunoglobulin M chemistry Disease Progression biology.protein Kidney Failure Chronic Female medicine.symptom business Glomerular Filtration Rate |
| Zdroj: | Clinical and Experimental Nephrology. 23:371-379 |
| ISSN: | 1437-7799 1342-1751 |
| DOI: | 10.1007/s10157-018-1651-6 |
| Popis: | BackgroundGlomerular immunoglobulin G deposition in patients with immunoglobulin A nephropathy (IgAN) has been shown to be associated with adverse renal outcomes. Clinical significance of mesangial immunoglobulin M (IgM) deposition in these patients remains to be proven.MethodsOne hundred patients who had a diagnosis of IgAN between 2001 and 2017 were enrolled. Patients were divided into two groups based on mesangial IgM deposition status. Groups were compared for demographic, clinical, and pathologic variables at baseline and in follow-up. Cox regression analysis was performed to evaluate the effect of mesangial IgM positivity on renal survival.ResultsIgM-positive group included 51% of participants. Baseline demographic and clinical parameters were not significantly different between groups. Mesangial IgM deposition was significantly associated with a higher segmental sclerosis score (p=0.008). At last visit, median serum creatinine was higher (p=0.021) and eGFR was lower (p=0.006) in IgM-positive group. Nineteen (19%) of all patients reached the combined primary outcome which includes doubling in serum creatinine or evolution to ESRD. Cumulative renal survival was lower (p=0.001) and resistant disease was more frequent in IgM-positive group (p=0.026). Renal survival at 15years was 94.2% and 59.7% in IgM-negative and IgM-positive groups, respectively (p=0.006). Time-averaged proteinuria (HR 2.9; 95% CI 1.9-4.5; p |
| Databáze: | OpenAIRE |
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