A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy.
A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy.
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DOI：
10.1038/s41598-021-84715-7
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发表时间：
2021-03-09
影响因子：
4.6
通讯作者：
Qin W
中科院分区：
文献类型：
--
作者：
Tan L;Tang Y;Pei G;Zhong Z;Tan J;Zhou L;Wen D;Sheikh-Hamad D;Qin W
有报道称，组织病理损害是IgA肾病(IgAN)进展的危险因素。本研究的目的是探讨IgA肾病患者肾小球系膜C1q沉积与肾脏预后的关系。从2013年1月至2017年1月，在多个研究中心登记了1071例经肾活检确诊的原发性IgAN患者。患者分为两组：C1q阳性组和C1q阴性组。使用1：4倾向评分匹配(PSM)方法确定年龄、性别和治疗方式以最小化混杂因素，将匹配的580名(926名)C1q阴性患者与145名C1q阳性患者进行比较，以评估基线临床病理特征和肾脏结果的严重性。进行Kaplan-Meier和Cox比例风险分析，以确定系膜C1q沉积是否与IgAN的肾脏预后有关。在随访期间(41.89 ± 22.85个月)，配对队列中C1q阴性组54例(9.31%)和C1q阳性组23例(15.86%)分别达到终点(EGFR50%下降和/或终末期肾病或死亡)(p = 0.01)。C1q阴性组在PSM前后的随访期内获得完全或部分缓解的患者显著多于C1q阴性组(P = 0.003)。无论是不匹配队列还是匹配队列，C1q阳性患者的三年、五年和七年肾脏存活率均显著低于C1q阴性患者(均p <； 0.05)。多因素COX回归分析显示，影响肾存活率的独立危险因素包括血肌酐、尿蛋白、T1-T2病变和C1q沉积。系膜C1q沉积是IgA肾病患者肾脏存活率差的预测指标。试用登记TCTR，TCTR20140515001。注册于2014年5月15日，http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074.
It was reported that histopathologic lesions are risk factors for the progression of IgA Nephropathy (IgAN). The aim of this study was to investigate the relationships between mesangial deposition of C1q and renal outcomes in IgAN. 1071 patients with primary IgAN diagnosed by renal biopsy were enrolled in multiple study centers form January 2013 to January 2017. Patients were divided into two groups: C1q-positive and C1q-negative. Using a 1: 4 propensity score matching (PSM) method identifying age, gender, and treatment modality to minimize confounding factors, 580 matched (out of 926) C1q-negative patients were compared with 145 C1q-positive patients to evaluate severity of baseline clinicopathological features and renal outcome. Kaplan–Meier and Cox proportional hazards analyses were performed to determine whether mesangial C1q deposition is associated with renal outcomes in IgAN. During the follow-up period (41.89 ± 22.85 months), 54 (9.31%) patients in the C1q negative group and 23 (15.86%) patients in C1q positive group reached the endpoint (50% decline of eGFR and/or ESRD or death) respectively (p = 0.01) in the matched cohort. Significantly more patients in C1q negative group achieved complete or partial remission during the follow up period (P = 0.003) both before and after PSM. Three, 5 and 7-year renal survival rates in C1q-positive patients were significantly lower than C1q-negative patients in either unmatched cohort or matched cohort (all p < 0.05). Furthermore, multivariate Cox regression analysis showed that independent risk factors influencing renal survival included Scr, urinary protein, T1-T2 lesion and C1q deposition. Mesangial C1q deposition is a predictor of poor renal survival in IgA nephropathy. Trial registration TCTR, TCTR20140515001. Registered May 15, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074.
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影响因子：
2.8
作者：
Tan, Li;Tang, Yi;Qin, Wei
通讯作者：
Qin, Wei
影响因子：
19.6
作者：
WOODROFFE, AJ;GORMLY, AA;CLARKSON, AR
通讯作者：
CLARKSON, AR
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DOI：
10.12659/msm.903102
发表时间：
2017-02-06
期刊：
Medical science monitor : international medical journal of experimental and clinical research
影响因子：
--
作者：
Yang X;Wei RB;Wang Y;Su TY;Li QP;Yang T;Huang MJ;Li KY;Chen XM
通讯作者：
Chen XM
影响因子：
19.6
作者：
Cattran, Daniel C.;Coppo, Rosanna;Zhang, Hong
通讯作者：
Zhang, Hong
影响因子：
13.6
作者：
Sethi, Sanjeev;Haas, Mark;Fervenza, Fernando C.
通讯作者：
Fervenza, Fernando C.