Glomerular IgG deposition predicts renal outcome in patients with IgA nephropathy.
Glomerular IgG deposition is frequently observed in patients with IgA nephropathy. However, the association between glomerular IgG deposition and progression of IgA nephropathy is uncertain. Six hundred and twenty-seven patients with biopsy-proven IgA nephropathy were recruited. Histological variables of the Oxford classification (Oxford-MEST) and the presence of glomerular IgG deposits were assessed. Renal progression defined as end-stage renal disease or 50% reduction in estimated glomerular filtration rate was analyzed using Kaplan-Meier methods and Cox regression analysis. Of the study population, 200 patients (31.9%) had glomerular IgG deposition on immunofluorescence staining. During a mean follow-up of 56.8±37.5 months, the rate of renal progression was significantly higher in the IgA nephropathy patients with glomerular IgG deposition compared with the IgA nephropathy patients without glomerular IgG deposition (39.8 vs 12.3 per 1000 patient-years; P<0.001). Of patients with IgG deposition, 178 (28.3%), 20 (3.2%), and 2 (0.3%) patients had mild, moderate, and marked glomerular IgG deposits, receptively. Kaplan-Meier analysis revealed that cumulative renal survival was significantly lower in IgA nephropathy patients with the higher intensity of glomerular IgG deposits (P<0.001). In addition, Cox regression analysis revealed that moderate and marked glomerular IgG deposits significantly predicted renal outcome independent of Oxford-MEST and clinical variables (HR, 2.97; 95% CI, 1.01-8.77; P=0.04). This study showed that that glomerular IgG deposition was independently associated with poor renal outcome in patient with IgA nephropathy.
Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University, Seoul, Korea.
Dong Ho
DH
Shin
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Beom Jin
BJ
Lim
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
In Mi
IM
Han
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Seung Gyu
SG
Han
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Young Eun
YE
Kwon
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kyoung Sook
KS
Park
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Mi Jung
MJ
Lee
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Hyung Jung
HJ
Oh
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Jung Tak
JT
Park
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Seung Hyeok
SH
Han
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Shin-Wook
SW
Kang
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Tae-Hyun
TH
Yoo
D000328:Adult; D062186:Arterial Pressure / Q000502:physiology; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D005922:Glomerulonephritis, IGA / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D011379:Prognosis
D007074:Immunoglobulin G