YuanFan Rui1, ZiJun Yang1, ZiHan Zhai1, Cong Zhao1, Lin Tang2. 1. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, Henan Province, China. 2. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Road, Zhengzhou, Henan Province, China. tanglin@zzu.edu.cn.
Abstract
PURPOSE: To analyze the efficacy of immunosuppressive therapy in IgA nephropathy and investigate the value of all clinicopathologic indicators. METHOD: One hundred and one eligible IgA nephropathy patients were retrospectively studied. All the patients received immunosuppressive treatment and were then grouped according to the treatment outcome. The endpoint was a composite outcome (halving eGFR, end-stage renal disease (ESRD) or death due to kidney disease). The outcomes of immunosuppressive therapy were evaluated, and the factors influencing the outcomes of immunosuppressive therapy were analyzed by logistics regression. The independent significance of clinicopathologic indicators on renal outcome was then analyzed by multivariable Cox regression. RESULTS: Multivariate logistic regression analysis showed that S1 and M1 were the risk factors for the immunosuppressive treatment effect in IgAN patients, and eGFR was the protective factor for the immunosuppressive treatment effect in IgAN patients. Kaplan-Meier analysis revealed that outcomes of immunosuppressive therapy were significantly associated with poor renal outcomes. Multiple Cox regression analysis further confirmed that M1, T2, and the initial level of eGFR were independent predictive factors for poor renal outcomes. CONCLUSIONS: M, S scores and initial eGFR are independent predictors of outcomes of immunosuppressive therapy. Only M, T scores can effectively predict poor renal outcomes after immunosuppressive therapy. Nonetheless, stable eGFR and low proteinuria can protect renal outcomes.
PURPOSE: To analyze the efficacy of immunosuppressive therapy in IgA nephropathy and investigate the value of all clinicopathologic indicators. METHOD: One hundred and one eligible IgA nephropathy patients were retrospectively studied. All the patients received immunosuppressive treatment and were then grouped according to the treatment outcome. The endpoint was a composite outcome (halving eGFR, end-stage renal disease (ESRD) or death due to kidney disease). The outcomes of immunosuppressive therapy were evaluated, and the factors influencing the outcomes of immunosuppressive therapy were analyzed by logistics regression. The independent significance of clinicopathologic indicators on renal outcome was then analyzed by multivariable Cox regression. RESULTS: Multivariate logistic regression analysis showed that S1 and M1 were the risk factors for the immunosuppressive treatment effect in IgAN patients, and eGFR was the protective factor for the immunosuppressive treatment effect in IgAN patients. Kaplan-Meier analysis revealed that outcomes of immunosuppressive therapy were significantly associated with poor renal outcomes. Multiple Cox regression analysis further confirmed that M1, T2, and the initial level of eGFR were independent predictive factors for poor renal outcomes. CONCLUSIONS: M, S scores and initial eGFR are independent predictors of outcomes of immunosuppressive therapy. Only M, T scores can effectively predict poor renal outcomes after immunosuppressive therapy. Nonetheless, stable eGFR and low proteinuria can protect renal outcomes.
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Authors: Mark Haas; Jacobien C Verhave; Zhi-Hong Liu; Charles E Alpers; Jonathan Barratt; Jan U Becker; Daniel Cattran; H Terence Cook; Rosanna Coppo; John Feehally; Antonello Pani; Agnieszka Perkowska-Ptasinska; Ian S D Roberts; Maria Fernanda Soares; Hernan Trimarchi; Suxia Wang; Yukio Yuzawa; Hong Zhang; Stéphan Troyanov; Ritsuko Katafuchi Journal: J Am Soc Nephrol Date: 2016-09-09 Impact factor: 10.121