Gao Li, Zhang Xuan, Yu Dongrong, Zhu Hong, Zhu Qin
Department of Nephrology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453, Stadium Road, Xihu District, Hangzhou, Zhejiang Province, 310007, People's Republic of China.
Int Urol Nephrol. 2025 Apr 29. doi: 10.1007/s11255-025-04529-8.
The aim of this study is to analyze the 5 year prognosis of IgA nephropathy (IgAN) patients with varying degrees of foot process effacement (FPE).
We retrospectively analyzed the clinical and pathological data of 863 patients with primary IgAN confirmed by renal biopsy at Hangzhou Traditional Chinese Medicine Hospital from 1 January 2015 to 31 December 2018. According to the degree of FPE, the group was divided into extensive FPE group and segmental FPE group. After propensity score matching (PSM), the effect of different levels of FPE on the prognosis of IgAN was analyzed using Log-rank tests.
Notably, 61(7.1%) of the 863 patients reached renal composite endpoint. 53 patients in the foot process extensive effacement group were matched with 100 patients in the segmental effacement group after propensity score matching. There were no significant differences in any of the baseline characteristics between the two groups (P > 0.05). Additionally, Kaplan-Meier survival analysis revealed that patients with extensive FPE (≥ 50%) exhibited a significantly poorer prognosis compared with those with segmental FPE (< 50%) (Log-rank test P = 0.030).In the Pearson correlation analysis, FPE was moderately positively associated with albuminuria and mildly negatively associated with eGFR.
Extensive foot process effacement is an independent risk factor for IgAN prognosis.
本研究旨在分析不同程度足突融合（FPE）的IgA肾病（IgAN）患者的5年预后情况。
我们回顾性分析了2015年1月1日至2018年12月31日在杭州市中医院经肾活检确诊的863例原发性IgAN患者的临床和病理资料。根据FPE程度，将该组患者分为广泛FPE组和节段性FPE组。经过倾向评分匹配（PSM）后，采用对数秩检验分析不同水平FPE对IgAN预后的影响。
值得注意的是，863例患者中有61例（7.1%）达到肾脏复合终点。倾向评分匹配后，足突广泛融合组的53例患者与节段性融合组的100例患者进行了匹配。两组的任何基线特征均无显著差异（P>0.05）。此外，Kaplan-Meier生存分析显示，广泛FPE（≥50%）的患者与节段性FPE（<50%）的患者相比，预后明显较差（对数秩检验P=0.030）。在Pearson相关性分析中，FPE与蛋白尿呈中度正相关，与估算肾小球滤过率（eGFR）呈轻度负相关。
广泛足突融合是IgAN预后的独立危险因素。
