The Journal of Practical Medicine >

2024 , Vol. 40 >Issue 22: 3172 - 3178

DOI: https://doi.org/10.3969/j.issn.1006-5725.2024.22.009

Clinical Research

Impact of IgM deposition level on the ultrastructure and the clinicopathological features of primary IgA nephropathy patients

  • Lu XU ,
  • Jingjing ZHANG ,
  • Qiqi YAN ,
  • Wenting XU ,
  • Huai LI ,
  • Deguang. WANG
Expand
  • Department of Nephrology，Second Affiliated Hospital of Anhui Medical University，Hefei 230601，Anhui，China

Received date: 2024-04-15

  Online published: 2024-11-25

Fold

Abstract

Objective To investigate the correlations between IgM deposition levels，glomerular ultrastructural and clinicopathological features in primary IgA nephropathy（IgAN）. Methods Data from 155 IgAN patients were categorized into three cohorts by IgM deposition levels. We assessed differences in glomerular ultrastructure， clinical indices， MEST-C scores， and factors influencing IgM deposition levels. Results The marked IgM cohort showed higher urinary protein， IgG deposition， and T scores， with reduced serum albumin and lymphocyte counts （P < 0.05）. Logistic regression identified FPE and T score as independent factors for IgM deposition. Conclusions IgM deposition correlates with FPE severity in IgAN， suggesting its utility in assessing renal damage and guiding treatment strategies.

Key words： IgA nephropathy; IgM deposition; foot process effacement; electron microscope

Cite this article

Lu XU , Jingjing ZHANG , Qiqi YAN , Wenting XU , Huai LI , Deguang. WANG . Impact of IgM deposition level on the ultrastructure and the clinicopathological features of primary IgA nephropathy patients[J]. The Journal of Practical Medicine, 2024 , 40(22) : 3172 -3178 . DOI: 10.3969/j.issn.1006-5725.2024.22.009

References

1 ZHANG Y M， ZHOU X J， SHI S F， et al. Homocysteine and IgA nephropathy： observational and Mendelian randomization analyses［J］. Chin Med J （Engl）， 2020，133（3）：277-284. doi:10.1097/cm9.0000000000000613
2 廖纯玲， 周添标. 细胞免疫在IgA肾病发病中作用的研究进展［J］. 实用医学杂志， 2019，35（22）：3558-3562+3567. doi:10.3969/j.issn.1006-5725.2019.22.029
3 WANG Z， XIE X， LI J， et al. Complement Activation Is Associated With Crescents in IgA Nephropathy［J］. Front Immunol， 2021，12：676919. doi:10.3389/fimmu.2021.676919
4 姚晓甜， 杨满球， 杨小兵. 肾组织病理积分联合肾衰竭风险方程在预测中晚期IgA肾病进展风险中的应用［J］. 实用医学杂志，2023，39（10）：1274-1277. doi:10.3969/j.issn.1006-5725.2023.10.015
5 HEYBELI C， OKTAN M A， YILDIZ S， et al. Clinical significance of mesangial IgM deposition in patients with IgA nephropathy［J］. Clin Exp Nephrol， 2019，23（3）：371-379. doi:10.1007/s10157-018-1651-6
6 KATAFUCHI R， NAGAE H， MASUTANI K， et al. Comprehensive evaluation of the significance of immunofluorescent findings on clinicopathological features in IgA nephropathy［J］. Clin Exp Nephrol， 2019，23（2）：169-181. doi:10.1007/s10157-018-1619-6
7 HAO Y， ZHAO Y， HUANG R， et al. Analysis of the relationship between Oxford classification， IgM deposition and multiple indexes and the adverse prognosis of patients with primary IgA nephropathy and related risk factors［J］. Exp Ther Med， 2019，17（2）：1234-1239.
8 TERINTE-BALCAN G， STANCU S， ZUGRAVU A， et al. Prognostic role of glomerular electron microscopy lesions in IgA nephropathy： "the devil is in the details"［J］. J Nephrol， 2023，36（8）：2233-2243. doi:10.1007/s40620-023-01744-3
9 TERINTE-BALCAN G， STEFAN G. A closer look： ultrastructural evaluation of high-risk progression IgA nephropathy［J］. Ultrastruct Pathol， 2023，47（6）：461-469. doi:10.1080/01913123.2023.2256836
10 TAN L， TANG Y， PEI G Q， et al. Mesangial IgM deposition predicts renal outcome in patients with IgA nephropathy： A multicenter， observational study［J］. Clin Exp Med， 2021，21（4）：599-610. doi:10.1007/s10238-021-00703-1
11 赵若蓓， 罗宇珍， 潘玲， 等. 足突融合与IgA肾病临床病理特征及肾功能的关系［J］. 实用医学杂志， 2021，37（10）：1268-1271. doi:10.3969/j.issn.1006-5725.2021.10.007
12 LEE J H， JANG S H， CHO N J， et al. Severity of foot process effacement is associated with proteinuria in patients with IgA nephropathy［J］. Kidney Res Clin Pract， 2020，39（3）：295-304. doi:10.23876/j.krcp.20.017
13 ROYAL V， ZEE J， LIU Q， et al. Ultrastructural Characterization of Proteinuric Patients Predicts Clinical Outcomes［J］. J Am Soc Nephrol， 2020，31（4）：841-854. doi:10.1681/asn.2019080825
14 INKER L A， ENEANYA N D， CORESH J， et al. New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race［J］. N Engl J Med， 2021，385（19）：1737-1749. doi:10.1056/nejmoa2102953
15 ZHANG Y， GUO L， WANG Z， et al. External Validation of International Risk-Prediction Models of IgA Nephropathy in an Asian-Caucasian Cohort［J］. Kidney Int Rep， 2020，5（10）：1753-1763. doi:10.1016/j.ekir.2020.07.036
16 Disease Kidney ： Improving Global Outcomes （KDIGO） Glomerular Diseases Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases［J］. Kidney Int， 2021，100（4S）：S1-S276.
17 YUAN X， SU Q， WANG H， et al. Genetic Variants of the COL4A3， COL4A4， and COL4A5 Genes Contribute to Thinned Glomerular Basement Membrane Lesions in Sporadic IgA Nephropathy Patients［J］. J Am Soc Nephrol， 2023，34（1）：132-144. doi:10.1681/asn.2021111447
18 PENG S， LU W， JIANG X， et al. IgG deposits in the mesangium and capillary loops predict poor renal outcome in patients with IgA nephropathy： A single-center retrospective study［J］. Renal Failure， 2020，42（1）：902-911. doi:10.1080/0886022x.2020.1811120
19 TURGUTALP K， CEBECI E， TURKMEN A， et al. The relationship between glomerular IgG staining and poor prognostic findings in patients with IgA nephropathy： The data from TSN-GOLD working group［J］. BMC Nephrol， 2021，22（1）：352. doi:10.1186/s12882-021-02560-2
20 STEFAN G， STANCU S， ZUGRAVU A， et al. Prognostic role of mesangial IgM deposition in IgA nephropathy： A long-term cohort study［J］. Ren Fail， 2024，46（1）：2313179. doi:10.1080/0886022x.2024.2313179
21 DI D， LIU L， WANG Y， et al. Crescents proportions above 10% are associated with unfavorable kidney outcomes in IgA nephropathy patients with partial crescent formation［J］. Ren Fail， 2023，45（1）：2226257. doi:10.1080/0886022x.2023.2226257
22 CASTER D J， ABNER C W， WALKER P D， et al. Clinicopathological Characteristics of Adult IgA Nephropathy in the United States［J］. Kidney Int Rep， 2023，8（9）：1792-1800. doi:10.1016/j.ekir.2023.06.016
23 BAGCHI S， UPADHYAY A D， BARWAD A， et al. The International IgA Nephropathy Network Prediction Tool Underestimates Disease Progression in Indian Patients［J］. Kidney Int Rep， 2022，7（6）：1210-1218. doi:10.1016/j.ekir.2022.03.016
24 HAAS M， SESHAN S V， BARISONI L， et al. Consensus definitions for glomerular lesions by light and electron microscopy： Recommendations from a working group of the Renal Pathology Society［J］. Kidney Int， 2020，98（5）：1120-1134. doi:10.1016/j.kint.2020.08.006
25 TANG X， YUAN Y， LIANG X， et al. Mitofusin2 expression is associated with podocyte injury in IgA nephropathy［J］. Eur J Med Res， 2023，28（1）：142. doi:10.1186/s40001-023-01107-5
26 LEVIN A， SCHWARZ A， HULKKO J， et al. The role of dendrin in IgA nephropathy［J］. Nephrol Dial Transplant， 2023，38（2）：311-321. doi:10.1093/ndt/gfac208
27 XU M， YI M， LI N. MicroRNA-17-5p restrains the dysfunction of Ang-II induced podocytes by suppressing secreted modular calcium-binding protein 2 via NF-kappaB and TGFbeta signaling［J］. Environ Toxicol， 2021，36（7）：1402-1411. doi:10.1002/tox.23136
Options
Outlines

/

〈 〉