AUTHOR=Dong Lingqiu , Tan Jiaxing , Li Fangming , Wang Siqing , Jiang Zheng , Qin Aiya , Zhong Zhengxia , Zhou Xiaoyuan , Tang Yi , Qin Wei 

TITLE=Arterial-Arteriolar Sclerosis Is Independently Associated With Poor Renal Outcome in IgA Nephropathy Patients

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.761897

DOI=10.3389/fmed.2021.761897

ISSN=2296-858X

ABSTRACT=Aims: This study aimed to investigate the clinicopathological features and prognosis of IgA nephropathy with arterial-arteriolar sclerosis (AS)
Methods: Patients with biopsy-proven IgA nephropathy from West China Hospital of Sichuan University were retrospectively enrolled. Clinicopathological features were collected. Patients were categorized based on the presence and the severity of the arterial-arteriolar sclerosis. All patients were regularly followed up until a composite endpoint. The correlation between arterial-arteriolar sclerosis and prognosis of IgA nephropathy was assessed.
Results: A total of 1424 patients were recruited and followed for 60.0±28.7 months. Patients with arterial-arteriolar sclerosis tended to have older age, higher blood pressure, heavier proteinuria, higher serum creatinine, uric acid, and total triglyceride. Meanwhile, they were more likely to have a lower eGFR, hemoglobin, and albumin. At the end of follow-up, 126 patients in the AS group and 47 in the non-AS group had reached the composite endpoint (P<0.001). Arterial-arteriolar sclerosis was associated with the renal outcome (log-rank P<0.001) and was an independent risk factor for the progression of IgA nephropathy (P=0.049). The severity of arterial-arteriolar sclerosis was associated with renal outcomes (log-rank P<0.001) and there was a trend that it might serve as an independent risk marker for progression of IgAN. In subgroup analysis, patients presenting with arterial-arteriolar sclerosis and lower eGFR, albumin, and hemoglobin, or higher proteinuria, uric acid, and TG had a significant trend for a shorter time to reach the endpoint (log-rank P<0.001).
Conclusions: Arterial-arteriolar sclerosis was commonly seen in IgA nephropathy patients and was independently associated with the poor prognosis.
Key words: IgA nephropathy, arterial-arteriolar sclerosis, end-stage renal disease, renal survival, chronic kidney disease