PMID- 36538201 OWN - NLM STAT- MEDLINE DCOM- 20230313 LR - 20230321 IS - 1724-6059 (Electronic) IS - 1121-8428 (Linking) VI - 36 IP - 2 DP - 2023 Mar TI - Clinical significance of intrarenal vascular lesions in non-hypertensive patients with IgA nephropathy. PG - 429-440 LID - 10.1007/s40620-022-01511-w [doi] AB - BACKGROUND: The clinical significance of intrarenal vascular lesions has not been elucidated in primary IgA nephropathy (IgAN), especially in non-hypertensive subjects. METHODS: From January 2003 to December 2020, data of 3435 patients with biopsy-proven IgAN were reviewed. Two hundred-forty non-hypertensive patients who met the criteria for IgAN and had intrarenal vascular lesions (IgAN-vas) were selected. The control cohort was constructed with 1:1 matched cases of non-hypertensive IgAN patients without vascular lesions according to age, gender, estimated glomerular filtration rate (eGFR) and follow-up time. RESULTS: The IgAN-vas cohort had significantly higher serum uric acid levels than the control IgAN cohort (P < 0.05); glomerulosclerosis was more common in IgAN-vas patients. Moreover, cluster analysis indicated that the serum uric acid level was associated with serum creatinine (s-Cr) levels in IgAN-vas while it was associated with serum lactate dehydrogenase (LDH) levels in control cases with IgAN. Both Kaplan-Meier analysis and generalized linear mixed-effects models revealed that the prognosis of the IgAN-vas cohort was significantly worse than that of the IgAN cohort after > 5 years of follow-up. Intimal thickening was an independent risk factor associated with reaching the endpoint (eGFR decrease >/= 30% from the baseline or reaching end-stage renal disease [ESRD] or death). CONCLUSIONS: The prognosis of non-hypertensive patients with IgAN-vas was worse than that of matched individuals with IgAN. The clinicopathologic manifestation of IgAN-vas was more severe, and included a higher proportion of glomerulosclerosis, and a higher serum uric acid level correlated with renal function impairment. CI - (c) 2022. The Author(s) under exclusive licence to Italian Society of Nephrology. FAU - Huang, Ziyuan AU - Huang Z AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Hu, Ya AU - Hu Y AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Chen, Bo AU - Chen B AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Liang, Yan AU - Liang Y AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Li, Duo AU - Li D AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Qiu, Wenxian AU - Qiu W AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. FAU - Zhang, Ji AU - Zhang J AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. zhji0426@gmail.com. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. zhji0426@gmail.com. FAU - Chen, Chaosheng AU - Chen C AD - Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Ouhai District, Wenzhou, 325000, Zhejiang, People's Republic of China. wzccs8@163.com. AD - Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China. wzccs8@163.com. LA - eng GR - LY22H050004/Natural Science Foundation of Zhejiang Province/ PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221220 PL - Italy TA - J Nephrol JT - Journal of nephrology JID - 9012268 RN - 268B43MJ25 (Uric Acid) SB - IM MH - Humans MH - *Glomerulonephritis, IGA/complications/diagnosis/pathology MH - Uric Acid MH - Clinical Relevance MH - *Kidney Failure, Chronic/complications MH - Prognosis MH - Retrospective Studies MH - Glomerular Filtration Rate MH - Disease Progression OTO - NOTNLM OT - Chronic Kidney diseases OT - Clinicopathology OT - IgA nephropathy OT - Intrarenal vascular lesions OT - Prognosis EDAT- 2022/12/21 06:00 MHDA- 2023/03/14 06:00 CRDT- 2022/12/20 11:19 PHST- 2022/07/11 00:00 [received] PHST- 2022/10/24 00:00 [accepted] PHST- 2022/12/21 06:00 [pubmed] PHST- 2023/03/14 06:00 [medline] PHST- 2022/12/20 11:19 [entrez] AID - 10.1007/s40620-022-01511-w [pii] AID - 10.1007/s40620-022-01511-w [doi] PST - ppublish SO - J Nephrol. 2023 Mar;36(2):429-440. doi: 10.1007/s40620-022-01511-w. Epub 2022 Dec 20.