Lee Ji-Hye, Jang Si-Hyong, Cho Nam-Jun, Heo Nam Hun, Gil Hyo-Wook, Lee Eun Young, Moon Jong-Seok, Park Samel
Department of Pathology, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea.
Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
Kidney Res Clin Pract. 2020 Sep 30;39(3):295-304. doi: 10.23876/j.krcp.20.017.
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.
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.
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).
Severity of FPE had an impact on the degree of proteinuria and may be associated with the pathogenesis of IgAN.
蛋白尿是IgA肾病（IgAN）进展的重要危险因素，且与足突融合（FPE）的严重程度呈正相关。我们评估了FPE与蛋白尿及组织学特征（包括牛津分型）之间的关系。
对在单一中心接受肾活检并诊断为IgAN的患者进行回顾性研究。年龄小于18岁的患者以及可能存在继发性病因的患者被排除在研究之外。随后，我们评估了蛋白尿程度、FPE严重程度与组织学特征（包括牛津分型和其他免疫荧光染色）之间的关联。
我们机构共进行了805例肾活检，其中327例患者被诊断为IgAN。其中，82例患者被排除。FPE的严重程度对蛋白尿程度有影响。值得注意的是，弥漫性FPE组的尿蛋白量比罕见FPE组每天多约1.3g。在组织学特征中，M1评分和IgG免疫沉积影响FPE的严重程度（风险比[95%置信区间]分别为1.90[1.10至3.26]和3.77[1.66至8.54]）。
FPE的严重程度对蛋白尿程度有影响，可能与IgAN的发病机制有关。
