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A cross-sectional study in patients with IgA nephropathy of correlations between clinical data and pathological findings at the time of renal biopsy: a Japanese prospective cohort study

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Abstract

Background

The correlations between clinical data and pathological findings at the time of renal biopsy were investigated in IgA nephropathy patients.

Methods

771 patients diagnosed with IgA nephropathy by renal biopsy were enrolled. The correlations between clinical variables including eGFR, daily proteinuria, mean arterial pressure (MAP), serum uric acid (UA) values, and pathological parameters were examined. These patients were further divided into three groups: children (< 19 years old), young adults (19–60 years), and elderly patients (> 60 years).

Results

Daily proteinuria was moderately correlated with all pathological parameters (Rs = 0.23–0.49). The mesangial score, the percentage of glomeruli that contained endocapillary hypercellularity, cellular/fibrocellular crescents or tuft necrosis, and segmental glomerulosclerosis (GS) affected daily proteinuria most on multiple linear regression analysis (MLRA). eGFR, MAP, and serum UA levels were mainly correlated with the degree of GS and interstitial lesions. In children, the degree of cellular/fibrocellular crescents or tuft necrosis was correlated with not only daily proteinuria, but also decreased eGFR (Rs = 0.51, − 0.24). Endocapillary hypercellularity was the only independent variable related to daily proteinuria on MLRA.

Conclusion

In all age cohorts of IgA nephropathy patients, daily proteinuria was correlated with all histological parameters, including both acute and chronic glomerular lesions, and the mesangial score. Independent variables for daily proteinuria were the meangial score, acute histological lesions, and segmental GS on MLRA, whereas the remaining independent variable in the pediatric group was endocapillary hypercellurality. The clinical pathological correlation at the time of biopsy varied depending on the age group.

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Rare and Intractable Disease, from the Ministry of Health, Labour and Welfare of Japan. This research was supported by AMED under Grant Number JP19ek0109261.

Author information

Authors and Affiliations

  1. Department of Analytic Human Pathology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan

    Chisako Kamano & Akira Shimizu

  2. Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan

    Kensuke Joh

  3. Department of Pathology, Keio University School of Medicine, Tokyo, Japan

    Akinori Hashiguchi

  4. Department of Pathology, University of Occupational and Environmental Health, Fukuoka, Japan

    Satoshi Hisano

  5. Kidney Unit, National Hospital Organization Fukuoka-Higashi Medical Center, Fukuoka, Japan

    Ritsuko Katafuchi

  6. Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Tetsuya Kawamura

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  1. Chisako Kamano
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The Japan IgA nephropathy prospective cohort Study Group

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Correspondence to Akira Shimizu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted [16–174 (4401); Jikei University School of Medicine] and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Kamano, C., Shimizu, A., Joh, K. et al. A cross-sectional study in patients with IgA nephropathy of correlations between clinical data and pathological findings at the time of renal biopsy: a Japanese prospective cohort study. Clin Exp Nephrol 25, 509–521 (2021). https://doi.org/10.1007/s10157-021-02022-x

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