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Kidney Week

Abstract: TH-OR112

Association of IgM Deposition with Renal Outcomes in IgA Nephropathy: A Multicenter, Prospective, Observational Study

Session Information

  • Mostly IgA Nephropathy
    November 07, 2019 | Location: Ballroom C, Walter E. Washington Convention Center
    Abstract Time: 05:18 PM - 05:30 PM

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Tan, Li, West China Hospital, Chengdu, China
  • Zhong, Zhengxia, Affiliated Hospital of Zunyi Medical University, Guizhou, China, Guizhou, China
  • Pei, Gaiqin, West China Hospital, Chengdu, China
  • Qin, Wei, West China Hospital of Sichuan University, Chengdu, Sichuan, China
Background

The aim of this study was to investigate the relationships between co-deposition of IgM, clinicopathological features, and renal outcomes and whether IgM deposition is a novel marker for the response to patients with IgA nephropathy (IgAN).

Methods

A total of 1239 patients with primary IgAN diagnosed by renal biopsy were enrolled l from January 2013 to May 2018. The primary endpoint was the combined endpoint of a 50% decline in eGFR and/or ESRD. Responses to therapy included complete remission (CR), partial remission (PR), no response (NR) and ESRD. A 1: 1 propensity score matching (PSM) method was used to balance the covariates in all patients.

Results

Compared with IgM negative deposition(n=521), patients with IgM positive depositon (n=521) had higher level of Urine protein and higher proportion of M1, E1, C1/C2, deposition of IgG, C3, C4 and C1q (all P<0.05) at the time of biopsy. During the follow-up period (39.07±23.82 months), 76.39%, 60.08% patients in groups of IgM positive and negative deposition achieved CR or PR (P<0.001) respectively. According to Kaplan–Meier, renal survival rates in IgM negative and IgM positive groups were better both in unmacthed and matched cohort (both P<0.05). Furthermore, with 50% decline in eGFR and/or ESRD as the combined endpoint, multivariate Cox regression analysis of unmatched and matched cohort showed IgM deposition was an independent risk factors influencing renal survival.

Conclusion

IgM deposition in the glomerulus is associated with a poor renal outcome and severe pathologic features and did play a decisive role in renal progressio in IgAN patients.

Funding

  • Government Support - Non-U.S.