Microangiopathic Lesions in IgA Nephropathy: A Cohort Study
Abstract
RATIONALE & OBJECTIVE
Renal arteriolar microangiopathic lesions may occur in immunoglobulin A nephropathy (IgAN), but their role in disease progression remains unclear. We sought to understand the prevalence and character of microangiopathic lesions in IgAN and their role in disease progression.
STUDY DESIGN
A retrospective cohort study.
SETTING & PARTICIPANTS
In this study, we enrolled a Chinese cohort with 944 adult patients with IgAN who had been followed up for at least 1 year.
PREDICTORS
Renal arteriolar microangiopathic lesions.
OUTCOMES
Composite kidney end point event defined as a>50% reduction in estimated glomerular filtration rate, end-stage kidney disease, or death.
ANALYTICAL APPROACH
All kidney biopsies were independently reviewed by 2 investigators. Renal arteriolar microangiopathic lesions were detected using light microscopy. Multivariable Cox regression analysis was used to test the association between microangiopathic lesions and the outcomes.
RESULTS
Overall, 194 (20.6%) patients had renal arteriolar microangiopathic lesions. Patients with microangiopathic lesions presented with higher blood pressures, more severe proteinuria, and lower estimated glomerular filtration rates (all P<0.001) than patients without microangiopathic lesions. After a median follow-up of 4.2 years, 75 (38.7%) patients with microangiopathic lesions and 83 (11.1%) patients without these lesions reached the composite kidney end point (P<0.001). In a multivariable Cox regression model…
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