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Overlapping obesity-related glomerulopathy and immunoglobulin A nephropathy: clinical and pathologic characteristics and prognosis

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Abstract

Background

In this study, we investigated the clinical and pathologic characteristics and prognosis of overlapping obesity-related glomerulopathy (ORG) and immunoglobulin A nephropathy (IgAN) (ORG + IgAN), which is rare in the clinic.

Methods

We included 62 cases of ORG + IgAN, 110 cases of ORG without other glomerulopathy (ORG alone) and 124 cases of IgAN without other glomerulopathy (IgAN alone). The clinical, pathologic and prognostic data were collected and compared.

Results

ORG + IgAN patients showed a higher incidence of body mass index (BMI), higher incidence of hyperuricemia, higher incidence of hypertriglyceridemia and higher blood glucose than the IgAN alone(all P < 0.05). ORG + IgAN patients presented with higher incidence of microscopic hematuria, greater mesangial cell proliferation and a higher proportion of crescents than the ORG alone (all P < 0.05). The ORG + IgAN patients who received corticosteroid or immunosuppressive therapy achieved a higher cumulative rate of partial or complete remission (PR or CR, P = 0.009). However, there was no significant difference in the cumulative renal survival rate between the ORG + IgAN patients in the glucocorticoids/immunosuppressors and non-glucocorticoids/immunosuppressors groups (P = 0.356). Obesity-related focal segmental glomerulosclerosis (O-FSGS) and body mass index (BMI) were significantly associated with poor prognosis (all P < 0.05).

Conclusions

ORG + IgAN should be considered in obese patients who present with metabolic abnormalities and microscopic hematuria. Although corticosteroid or immunosuppressive therapy achieves higher cumulative incidence rates of PR or CR, there is no benefit to long-term prognosis but an increased risk of infection. Moreover, O-FSGS and BMI are significantly associated with poor prognosis.

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Acknowledgements

We thank the staff of the department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou. This work was supported by National Natural Science Foundation of China Grant 81570645, Innovation Scientists and Technicians Troop Construction Projects of Henan Province grant 2018JR0014, Program for Science and Technology Innovation Talents in Universities of Henan Province Grant 18HASTIT043, Major Project of Henan Medical Science and Technology Research Program Grant 201501018, Science and Technology Huimin Project of Henan Province Grant 162207310001, and Pathogenesis and Precision diagnosis and treatment of Chronic Kidney Disease Grant 182101510002. All the authors declared no competing interests.

Funding

This work was supported by National Natural Science Foundation of China Grant 81570645, Innovation Scientists and Technicians Troop Construction Projects of Henan Province Grant 2018JR0014, Program for Science and Technology Innovation Talents in Universities of Henan Province Grant 18HASTIT043, Major Project of Henan Medical Science and Technology Research Program Grant 201501018, Science and Technology Huimin Project of Henan Province Grant 162207310001, and Pathogenesis and Precision diagnosis and treatment of Chronic Kidney Disease Grant 182101510002.

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Author notes

  1. Junjun Zhang and Yongli Wang are first authors.

Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China

    Junjun Zhang, Yongli Wang, Zhangsuo Liu, Bo Huang, Xutong Wang, Minhua Xie, Dan Yu, Ruxue Guo & Panfei Wang

  2. Academy of Medical Science, Zhengzhou University, Zhengzhou, People’s Republic of China

    Bo Huang

  3. Research Institute of Nephrology, Zhengzhou University, Zhengzhou, People’s Republic of China

    Zhangsuo Liu

  4. Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, People’s Republic of China

    Zhangsuo Liu

  5. Core Unit of National Clinical Medical Research Center of Kidney Disease, Zhengzhou, People’s Republic of China

    Zhangsuo Liu

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  1. Junjun Zhang
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Contributions

JZ and ZL designed the study, interpreted the data. YW drafted the manuscript. BH and XW followed the patients. MX, DY, RG and PW collected and analyzed the data. All authors participated in critically reviewing the article and approved the final version of the manuscript for publication.

Corresponding authors

Correspondence to Junjun Zhang or Zhangsuo Liu.

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No conflicts of interest need to be declared.

Ethics statement

This study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of The First Affiliated Hospital of Zhengzhou University (China) (Ethics: 2020-KY-435). The requirement for informed consent from the participants was waived due to the retrospective nature of this study.

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Zhang, J., Wang, Y., Liu, Z. et al. Overlapping obesity-related glomerulopathy and immunoglobulin A nephropathy: clinical and pathologic characteristics and prognosis. Clin Exp Nephrol 25, 865–874 (2021). https://doi.org/10.1007/s10157-021-02045-4

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  • DOI: https://doi.org/10.1007/s10157-021-02045-4

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