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To study the relationship between lymphocyte subsets and renal clinicopathological features and prognosis in patients with IgA nephropathy
Received date: 2024-10-23
Online published: 2025-02-19
Objective To examine the association between lymphocyte subsets and renal clinicopathological characteristics as well as prognosis in patients with IgA nephropathy （IgAN）. Methods The retrospective analysis included general clinical data and pathological examination results of IgAN patients diagnosed by renal biopsy at the Fourth Hospital of Hebei Medical University from January 2018 to January 2022. Correlation tests were conducted to examine the relationship between lymphocyte subsets and other significant clinicopathological parameters. The optimal cut?off value of CD4+ T determined using the Youden index， and patients were grouped accordingly. Kaplan?Meier survival curves and Cox regression analyses were employed to compare the low and high CD4+ T lymphocyte groups among IgAN patients， identifying factors influencing renal function progression. The endpoint event was defined as a decrease in estimated glomerular filtration rate （eGFR） of ≥ 30% from baseline， progression to end?stage renal disease （ESRD） ［eGFR < 15 mL/（min·1.73 m2） or initiation of renal replacement therapy］， or all?cause mortality. Results Low CD4+ T lymphocytes were significantly positively correlated with blood IgA levels and the proportion of glomerular crescents in IgAN patients （all P < 0.05）. This study included a total of 53 IgAN patients， divided into two groups based on CD4+ T lymphocyte counts： 20 patients in the low CD4+ T lymphocyte group and 33 patients in the high CD4+ T lymphocyte group. In the low CD4+ T lymphocyte group， there was a higher proportion of males and a lower proportion of glomerular crescents （P < 0.05）. Kaplan?Meier survival analysis revealed that patients with low CD4+ lymphocytes had a significantly lower cumulative renal survival rate （Log?Rank test χ2 = 4.188， P = 0.041）. Cox regression analysis indicated that low CD4+ lymphocytes were an independent risk factor for the progression of renal function decline in IgAN patients （HR = 2.614， 95% CI： 1.006 ~ 6.788， P = 0.048）. Conclusions Patients with higher levels of CD4+ T lymphocytes exhibit a lower risk of adverse renal outcomes. In contrast， patients with IgA nephropathy and low CD4+ T lymphocyte counts tend to have poorer renal survival rates.
Key words： IgA nephropathy; CD4+T lymphocytes; prognosis
Shenglei ZHANG , Ruicong TIAN , Jingjing JIN , Fan LU , Meijuan CHENG , Yaling BAI , Jinsheng. XU . To study the relationship between lymphocyte subsets and renal clinicopathological features and prognosis in patients with IgA nephropathy[J]. The Journal of Practical Medicine, 2025 , 41(3) : 352 -357 . DOI: 10.3969/j.issn.1006-5725.2025.03.007
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