Crescents proportions above 10% are associated with unfavorable kidney outcomes in IgA nephropathy patients with partial crescent formation
PURPOSE: Whether different crescentic proportions determine the progression of IgA nephropathy (IgAN) with crescents in less than 50% of glomeruli remains controversial. We aimed to evaluate the relationship between different proportions of crescents and kidney outcomes in IgAN with partial crescent formation.
METHODS: Patients diagnosed as IgAN, having at least two crescents and in less than 50% of glomeruli, were categorized into three groups: Group I (crescents in ≤10% of glomeruli), Group II (10%< crescents ≤25% of glomeruli) and Group III (crescents >25% of glomeruli). Baseline clinicopathological parameters were evaluated. The kidney endpoint was a composite of a ≥ 40% decline in the initial estimated glomerular filtration rate, end-stage kidney disease, and kidney disease-related death.
RESULTS: Of 183 IgAN patients with crescents in less than 50% of glomeruli, baseline 24-hour urinary protein and immunosuppressive treatment varied among the three groups (p < 0.05). During a median follow-up of 57 months (interquartile range 28-86), 50 (27.3%) patients reached the composite outcome. Kaplan-Meier survival analysis revealed that kidney survival in Group II (p = 0.049) and Group III (p = 0.008) was significantly shorter than in Group I, with no significant difference between Group II and III (p = 0.2). After adjusting for clinical factors and MEST score based on the multivariate Cox regression analysis, a crescent proportion >10% (HR = 3.431, 95% CI 1.067-11.03, p = 0.039) was predictive of time to unfavorable kidney outcome, with model adjustments improving predictability (c-index: 0.817).
CONCLUSION: The proportion of crescents reaching 10% of glomeruli in IgAN was identified as an independent risk factor for kidney survival.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
|---|---|
| Enthalten in: |
Renal failure - 45(2023), 1 vom: 25. Dez., Seite 2226257 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Di, Dingxin [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Clinicopathological characteristics |
|---|
| Anmerkungen: |
Date Completed 27.06.2023 Date Revised 01.07.2023 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1080/0886022X.2023.2226257 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM358587891 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM358587891 | ||
| 003 | DE-627 | ||
| 005 | 20231226075052.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1080/0886022X.2023.2226257 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1195.xml |
| 035 | |a (DE-627)NLM358587891 | ||
| 035 | |a (NLM)37357427 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Di, Dingxin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Crescents proportions above 10% are associated with unfavorable kidney outcomes in IgA nephropathy patients with partial crescent formation |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.06.2023 | ||
| 500 | |a Date Revised 01.07.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: Whether different crescentic proportions determine the progression of IgA nephropathy (IgAN) with crescents in less than 50% of glomeruli remains controversial. We aimed to evaluate the relationship between different proportions of crescents and kidney outcomes in IgAN with partial crescent formation | ||
| 520 | |a METHODS: Patients diagnosed as IgAN, having at least two crescents and in less than 50% of glomeruli, were categorized into three groups: Group I (crescents in ≤10% of glomeruli), Group II (10%< crescents ≤25% of glomeruli) and Group III (crescents >25% of glomeruli). Baseline clinicopathological parameters were evaluated. The kidney endpoint was a composite of a ≥ 40% decline in the initial estimated glomerular filtration rate, end-stage kidney disease, and kidney disease-related death | ||
| 520 | |a RESULTS: Of 183 IgAN patients with crescents in less than 50% of glomeruli, baseline 24-hour urinary protein and immunosuppressive treatment varied among the three groups (p < 0.05). During a median follow-up of 57 months (interquartile range 28-86), 50 (27.3%) patients reached the composite outcome. Kaplan-Meier survival analysis revealed that kidney survival in Group II (p = 0.049) and Group III (p = 0.008) was significantly shorter than in Group I, with no significant difference between Group II and III (p = 0.2). After adjusting for clinical factors and MEST score based on the multivariate Cox regression analysis, a crescent proportion >10% (HR = 3.431, 95% CI 1.067-11.03, p = 0.039) was predictive of time to unfavorable kidney outcome, with model adjustments improving predictability (c-index: 0.817) | ||
| 520 | |a CONCLUSION: The proportion of crescents reaching 10% of glomeruli in IgAN was identified as an independent risk factor for kidney survival | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a IgA nephropathy | |
| 650 | 4 | |a clinicopathological characteristics | |
| 650 | 4 | |a crescent | |
| 650 | 4 | |a prognosis | |
| 700 | 1 | |a Liu, Lin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Yue |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Shimin |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Wenge |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Renal failure |d 1995 |g 45(2023), 1 vom: 25. Dez., Seite 2226257 |w (DE-627)NLM012950394 |x 1525-6049 |7 nnns |
| 773 | 1 | 8 | |g volume:45 |g year:2023 |g number:1 |g day:25 |g month:12 |g pages:2226257 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1080/0886022X.2023.2226257 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 45 |j 2023 |e 1 |b 25 |c 12 |h 2226257 | ||