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Severity of foot process effacement is associated with proteinuria in patients with IgA nephropathy

Kidney Research and Clinical Practice 2020년 39권 3호 p.295 ~ 304
이지혜, 장시형, 조남준, 허남훈, 길효욱, 이은영, Moon Jong-Seok,
소속 상세정보
이지혜 ( Lee Ji-Hye ) - Soonchunhyang University College of Medicine Department of Pathology
장시형 ( Jang Si-Hyong ) - Soonchunhyang University College of Medicine Department of Pathology
조남준 ( Cho Nam-Jun ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
허남훈 ( Heo Nam-Hun ) - Soonchunhyang University Cheonan Hospital Department of Biostatistics
길효욱 ( Gil Hyo-Wook ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
이은영 ( Lee Eun-Young ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
 ( Moon Jong-Seok ) - Soonchunhyang University Soonchunhyang Institute of Medi-Bio Science

Abstract


Background: Proteinuria is a significant risk factor for progression of IgA nephropathy (IgAN) and has a positive correlation with severity of foot process effacement (FPE). We evaluated the relationship of FPE with proteinuria and histologic characteristics, including the Oxford classification.

Methods: Patients who underwent renal biopsy and were diagnosed with IgAN at a single center were retrospectively reviewed. Patients aged less than 18 years and those with the possibility of secondary causes were excluded from the study. Subsequently, we evaluated the association between degree of proteinuria, severity of FPE, and histologic characteristics, including the Oxford classification and other immunofluorescence stains.

Results: A total of 805 cases of renal biopsy was performed at our institution, and 327 patients were diagnosed with IgAN. Among them, 82 patients were excluded. Severity of FPE had an impact on the degree of proteinuria. Notably, the group with diffuse FPE had more than about 1.3 g/day of urine protein compared to those with rare FPE. Among the histologic characteristics, M1 score and immune deposition of IgG affected severity of FPE (hazard ratios [95% confidence interval], 1.90 [1.10 to 3.26], and 3.77 [1.66 to 8.54], respectively).

Conclusion: Severity of FPE had an impact on the degree of proteinuria and may be associated with the pathogenesis of IgAN.

키워드

Glomerulonephritis; Immunoglobulin A; Nephropathy; Podocytes; Proteinuria

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