Journal
RENAL FAILURE
Volume 43, Issue 1, Pages 1454-1462Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/0886022X.2021.1994996
Keywords
Blood pressure; IgA nephropathy; ischemic renal injury; prognosis; renal biopsy
Categories
Funding
- National Natural Science Foundation of China [81570645]
- Innovation Scientists and Technicians Troop Construction Projects of Henan Province [2018JR0014]
- Program for Science & Technology Innovation Talents in Universities of Henan Province [18HASTIT043]
- Major Project of Henan Medical Science and Technology Research Program [201501018]
- Science and Technology Huimin Project of Henan Province [162207310001]
- Pathogenesis & Precision diagnosis and treatment of Chronic Kidney Disease grant [182101510002]
Ask authors/readers for more resources
Ischemic renal injury can occur in normotensive IgAN patients, with pathological changes not affecting long-term prognosis. However, prognosis remains poor for hypertensive IgAN patients with ischemic renal injury, highlighting the need for increased clinical management attention.
Objectives This study aimed to investigate the clinicopathological characteristics and prognosis of normotensive and hypertensive IgAN patients with ischemic renal injury. Methods A total of 344 cases of IgAN with ischemic renal injury were included in the study, including 99 normotensive IgAN patients (28.8%) and 245 hypertensive IgAN patients (71.2%). In addition, 467 IgAN patients without ischemic renal injury were included as controls, including 205 normotensive patients and 262 hypertensive patients. Clinicopathological and prognostic data were collected and analyzed. Results Compared with patients without ischemic renal injury, IgAN patients with ischemic renal injury displayed a higher proportion of hypertention, a higher proportion of ischemic glomerulosclerosis, tubular atrophy/interstitial fibrosis and vascular lesions (all p < .05). There was no significant difference in cumulative survival between the normotensive IgAN patients groups (Log-rank chi(2) = 0.479; p = .489). Furthermore, ischemic renal injury was not a risk factor for end-point events in normotensive IgAN patients (HR = 1.103; 95% CI: 0.279-4.365; p = .889). There was lower cumulative survival in hypertensive IgAN patients with ischemic renal injury (Log-rank chi(2) = 11.352, p = .001). Moreover, ischemic renal injury was a risk factor for end-point events in hypertensive IgAN patients (HR = 1.889; 95% CI: 1.124-3.178; p = .016). Conclusions Ischemic renal injury can occur in normotensive IgAN patients. Although the pathological changes may not affect the long-term prognosis of normotensive IgAN patients, the prognosis for hypertensive IgAN patients remains poor. Therefore, increased attention should be paid to the clinical management of ischemic lesions in hypertensive IgAN patients.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available