Wu Qian, Chen Yi, Shen Miaoying, Cai Yuyuan, Yu Haokai, Zhou Lei, Yang Haifeng, Zou Chuan
Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
School of Mathematics and Physics, Southwest University of Science and Technology, Mianyang, Sichuan, China.
PLoS One. 2025 Apr 24;20(4):e0320635. doi: 10.1371/journal.pone.0320635. eCollection 2025.
The impact of chronic arteriolar lesions on the prognosis of IgA nephropathy remains controversial. This study aims to explore the value of chronic arteriolar lesions of varying degrees in predicting the prognosis of IgA nephropathy patients and analyze the associated risk factors that contribute to the formation.
A retrospective analysis was conducted on 853 patients diagnosed with IgA nephropathy through renal biopsy at Guangdong Provincial Hospital of Traditional Chinese Medicine between September 1, 2005, and December 31, 2021. Eventually, a total of 574 cases were included in this study. According to the degree of chronic arteriolar lesions, the patients were divided into four groups: no lesion group (n=115), mild lesion group (n=287), moderate lesion group (n=131), and severe lesion group (n=41). Relevant clinical and pathological features and renal outcomes were recorded. Kaplan-Meier analysis, Cox proportional hazards regression, and receiver operating characteristic (ROC) curve analysis were utilized to examine the relationship between different degrees of chronic arteriolar lesions and the prognosis of IgA nephropathy. Additionally, risk factors associated with the development of moderate to severe chronic arteriolar lesions were identified.
Worse clinical and pathological features were observed in the moderate to severe lesions group (P<0.05). Moderate to severe chronic arteriolar lesions (aHR=3.357, 95%CI: 1.018-11.071, P=0.047), creatinine, S1, E1, T2, and C2 were identified as independent risk factors for adverse renal outcomes. Cox multivariate regression analysis on moderate to severe chronic arteriolar lesions demonstrated that creatinine, T2, and C2 were independent risk factors for adverse renal outcomes in patients with moderate to severe chronic arteriolar lesions.
Moderate to severe chronic arteriolar lesions independently increases the risk of adverse renal outcomes.
慢性小动脉病变对IgA肾病预后的影响仍存在争议。本研究旨在探讨不同程度的慢性小动脉病变在预测IgA肾病患者预后方面的价值，并分析促成其形成的相关危险因素。
对2005年9月1日至2021年12月31日期间在广东省中医院通过肾活检确诊为IgA肾病的853例患者进行回顾性分析。最终，本研究共纳入574例病例。根据慢性小动脉病变程度，将患者分为四组：无病变组（n = 115）、轻度病变组（n = 287）、中度病变组（n = 131）和重度病变组（n = 41）。记录相关临床和病理特征以及肾脏结局。采用Kaplan-Meier分析、Cox比例风险回归和受试者工作特征（ROC）曲线分析来检验不同程度的慢性小动脉病变与IgA肾病预后之间的关系。此外，确定了与中度至重度慢性小动脉病变发生相关的危险因素。
中度至重度病变组观察到更差的临床和病理特征（P < 0.05）。中度至重度慢性小动脉病变（aHR = 3.357，95%CI：1.018 - 11.071，P = 0.047）、肌酐、S1、E1、T2和C2被确定为不良肾脏结局的独立危险因素。对中度至重度慢性小动脉病变进行的Cox多因素回归分析表明，肌酐、T2和C2是中度至重度慢性小动脉病变患者不良肾脏结局的独立危险因素。
中度至重度慢性小动脉病变独立增加不良肾脏结局的风险。
