Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study
Background The clinical significance of mesangial immunoglobulin (Ig) M deposition in IgA nephropathy (IgAN) has been less explored and remains a topic of debate. Therefore, our study aimed to investigate the prognostic value of mesangial IgM deposition in a long-term follow-up cohort of IgAN patien...
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Taylor & Francis Group
2024-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2313179 |
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| author | Gabriel Stefan Simona Stancu Adrian Zugravu George Terinte-Balcan |
| author_facet | Gabriel Stefan Simona Stancu Adrian Zugravu George Terinte-Balcan |
| author_sort | Gabriel Stefan |
| collection | DOAJ |
| description | Background The clinical significance of mesangial immunoglobulin (Ig) M deposition in IgA nephropathy (IgAN) has been less explored and remains a topic of debate. Therefore, our study aimed to investigate the prognostic value of mesangial IgM deposition in a long-term follow-up cohort of IgAN patients.Methods A unicentric retrospective study was conducted on 93 consecutive IgAN patients (median age 41 years, 68% male, eGFR 48.7 mL/min, proteinuria 1.1 g/g) from 2010 to 2015. They were followed until end-stage kidney disease (ESKD), death, or until the end of the study in January 2021, with a median follow-up of 7 years. An independent pathologist evaluated the IgM immunofluorescence pattern, Oxford MEST-C score, and transmission electron microscopy (TEM) lesions following a comprehensive protocol.Results In our cohort, 70% had mesangial IgM-positive deposits, while 30% were IgM-negative. Both groups were similar in age, sex, prevalence of arterial hypertension, Charlson comorbidity scores, kidney function (eGFR and proteinuria), pathology findings (Oxford MEST-C score, IgG and C3 immune deposition), and TEM analysis. Treatment with RASI and immunosuppression, and death rates were also comparable. However, 37% of IgM-positive patients progressed to ESKD, significantly higher than the 11% in the IgM-negative group. Univariate and multivariate Cox proportional hazards regression analyses identified lower eGFR, higher Oxford MEST-C score, and mesangial IgM deposits as independent factors associated with shorter kidney survival.Conclusions Our study highlights mesangial IgM deposition as a potential risk factor for ESKD in patients with advanced IgAN, laying a foundation for further research in this area. |
| format | Article |
| id | doaj-art-93746874c21f45c5be1af18621be7621 |
| institution | Kabale University |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
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| series | Renal Failure |
| spelling | doaj-art-93746874c21f45c5be1af18621be76212025-01-23T04:17:48ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146110.1080/0886022X.2024.2313179Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort studyGabriel Stefan0Simona Stancu1Adrian Zugravu2George Terinte-Balcan3Department of Nephrology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaDepartment of Nephrology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaDepartment of Nephrology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaDepartment of Nephrology, University of Medicine and Pharmacy “Carol Davila”, Bucharest, RomaniaBackground The clinical significance of mesangial immunoglobulin (Ig) M deposition in IgA nephropathy (IgAN) has been less explored and remains a topic of debate. Therefore, our study aimed to investigate the prognostic value of mesangial IgM deposition in a long-term follow-up cohort of IgAN patients.Methods A unicentric retrospective study was conducted on 93 consecutive IgAN patients (median age 41 years, 68% male, eGFR 48.7 mL/min, proteinuria 1.1 g/g) from 2010 to 2015. They were followed until end-stage kidney disease (ESKD), death, or until the end of the study in January 2021, with a median follow-up of 7 years. An independent pathologist evaluated the IgM immunofluorescence pattern, Oxford MEST-C score, and transmission electron microscopy (TEM) lesions following a comprehensive protocol.Results In our cohort, 70% had mesangial IgM-positive deposits, while 30% were IgM-negative. Both groups were similar in age, sex, prevalence of arterial hypertension, Charlson comorbidity scores, kidney function (eGFR and proteinuria), pathology findings (Oxford MEST-C score, IgG and C3 immune deposition), and TEM analysis. Treatment with RASI and immunosuppression, and death rates were also comparable. However, 37% of IgM-positive patients progressed to ESKD, significantly higher than the 11% in the IgM-negative group. Univariate and multivariate Cox proportional hazards regression analyses identified lower eGFR, higher Oxford MEST-C score, and mesangial IgM deposits as independent factors associated with shorter kidney survival.Conclusions Our study highlights mesangial IgM deposition as a potential risk factor for ESKD in patients with advanced IgAN, laying a foundation for further research in this area.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2313179IgA nephropathymesangial IgM depositionimmunofluorecenceend-stage kidney disease |
| spellingShingle | Gabriel Stefan Simona Stancu Adrian Zugravu George Terinte-Balcan Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study Renal Failure IgA nephropathy mesangial IgM deposition immunofluorecence end-stage kidney disease |
| title | Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study |
| title_full | Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study |
| title_fullStr | Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study |
| title_full_unstemmed | Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study |
| title_short | Prognostic role of mesangial IgM deposition in IgA nephropathy: a long-term cohort study |
| title_sort | prognostic role of mesangial igm deposition in iga nephropathy a long term cohort study |
| topic | IgA nephropathy mesangial IgM deposition immunofluorecence end-stage kidney disease |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2024.2313179 |
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