Hu Ya, Huang Ziyuan, Zhao Wanwan, Zhang Hong, Li Ganxiu, Lin Sishi, Feng Fangfang, Chen Chaosheng, Liu Zewen
Department of Nephrology, Fuyang People's Hospital affiliated with Anhui Medical University, Fuyang, China.
Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Kidney Res Clin Pract. 2025 Apr 25. doi: 10.23876/j.krcp.24.260.
Systemic immune inflammation index (SII) is a potential marker that can reflect the systemic inflammatory response. However, the clinical significance of SII for immunoglobulin A nephropathy (IgAN) has yet to be determined.
This was a retrospective analysis, covering January 2011 to December 2023, involving 1,399 IgAN patients confirmed through renal biopsy. The low TASII (L-TASII) group comprised patients with a time-average SII (TASII) below the top third of the cohort, whereas the high TASII (H-TASII) group included all remaining patients. All patients were matched 1:1 according to age, sex, follow-up time, and baseline estimated glomerular filtration rate (eGFR). Clinical pathology and prognosis were assessed and compared between the two groups.
After matching, the L-TASII and H-TASII groups each feature 556 cases. Patients in the H-TASII group had lower albumin levels (36.88 ± 6.24 g/L vs. 37.93 ± 5.45 g/L, p = 0.01) and higher proteinuria levels (2.19 ± 2.25 g/day vs. 1.75 ± 2.07 g/day, p = 0.003). With an eGFR ≥30% when compared with the baseline or end-stage renal disease as the composite endpoint events, Kaplan-Meier curve analysis revealed that after an average follow-up of 59.91 ± 32.42 months, the survival rate was markedly lower in the H-TASII group than in L-TASII group (log-rank p < 0.01). Analysis revealed that TASII levels are independent predictors for the occurrence of endpoint events (hazard ratio, 1.02; 95% confidence interval, 1.01-1.04; p = 0.001).
IgAN patients with a high TASII have more serious clinical manifestations such as creatinine, urinary protein, and inflammatory markers, while there is a worse prognosis for patients with low TASII. Thus, the TASII score represents a significant risk factor for adverse renal outcomes in IgAN patients and serves as a reliable predictor of renal survival.
全身免疫炎症指数（SII）是一种能够反映全身炎症反应的潜在标志物。然而，SII在免疫球蛋白A肾病（IgAN）中的临床意义尚未确定。
这是一项回顾性分析，涵盖2011年1月至2023年12月，纳入1399例经肾活检确诊的IgAN患者。低时间平均SII（L-TASII）组包括时间平均SII（TASII）低于队列前三分之一的患者，而高TASII（H-TASII）组包括其余所有患者。所有患者根据年龄、性别、随访时间和基线估计肾小球滤过率（eGFR）进行1:1匹配。对两组的临床病理和预后进行评估和比较。
匹配后，L-TASII组和H-TASII组各有556例。H-TASII组患者的白蛋白水平较低（36.88±6.24g/L对37.93±5.45g/L，p = 0.01），蛋白尿水平较高（2.19±2.25g/天对1.75±2.07g/天，p = 0.003）。以eGFR较基线下降≥30%或终末期肾病作为复合终点事件，Kaplan-Meier曲线分析显示，平均随访59.91±32.42个月后，H-TASII组的生存率明显低于L-TASII组（对数秩检验p<0.01）。分析显示，TASII水平是终点事件发生的独立预测因素（风险比，1.02；95%置信区间，1.01-1.04；p = 0.001）。
TASII高的IgAN患者有更严重的临床表现，如肌酐、尿蛋白和炎症标志物，而TASII低的患者预后较差。因此，TASII评分是IgAN患者不良肾脏结局的重要危险因素，也是肾脏生存的可靠预测指标。
