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Clinical and Experimental Nephrology

, Volume 22, Issue 5, pp 1116–1127 | Cite as

The features in IgA-dominant infection-related glomerulonephritis distinct from IgA nephropathy: a single-center study

  • Takaya Handa
  • Hiroko Kakita
  • Yu Tateishi
  • Tomomi Endo
  • Hiroyuki Suzuki
  • Toshiro Katayama
  • Tatsuo Tsukamoto
  • Eri Muso
Original article

Abstract

Background

IgA-dominant infection-related glomerulonephritis (IgA-IRGN) is a unique form of IRGN, which needs to be distinguished from IgA nephropathy (IgAN).

Methods

Thirteen patients with IgA-IRGN (IgA-IRGN group) and 122 with IgAN (IgAN group) were selected from 1788 patients who underwent kidney biopsy between 2000 and 2015 in Kitano Hospital. Data selected included clinical and serological parameters; light and electron microscope findings; immunofluorescence findings; and prognostic parameters like renal and overall survival and creatinine increase by > 50%. In addition, a 26-patient IgAN cohort (matching-IgAN), matching with IgA-IRGN group with respect to age, sex, estimated glomerular filtration rate (eGFR), and proteinuria was segregated for comparison.

Results

Compared to IgAN group, IgA-IRGN group were older, had lower hemoglobin, higher CRP, lower eGFR, heavier proteinuria, lower serum albumin, and higher serum IgG and IgA levels (p < 0.05). Endocapillary hypercellularity, deposition of immune complexes along the glomerular capillary wall, and subendothelial and subepithelial electron dense deposits were more frequently observed (p < 0.05); and they were more susceptible to renal dysfunction and poorer prognosis. After propensity score-matching, serum albumin was significantly lower in the IgA-IRGN group. Significantly subendothelial and subepithelial deposits were frequently observed in this group. Matching-IgAN group showed relatively advanced sclerotic lesions with more global sclerosis and fibrous crescent.

Conclusion

Local inflammation involved glomerular capillary wall in IgA-IRGN, in contrast to relatively chronic and sclerotic renal lesion in IgAN, might result in poorer prognosis in former, even under indistinguishable condition of deteriorated renal function and proteinuria.

Keywords

IgA nephropathy Infection Nephritis Kidney biopsy Histopathology 

Notes

Acknowledgements

The authors are also grateful to Medical English Service for editing the paper.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Informed consent

This was a retrospective study and used a preexisting database while employing the highest privacy policy standards. Therefore, the requirement of informed consent was waived.

Supplementary material

10157_2018_1564_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 KB)
10157_2018_1564_MOESM2_ESM.docx (21 kb)
Supplementary material 2 (DOCX 20 KB)

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Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Takaya Handa
    • 1
  • Hiroko Kakita
    • 1
  • Yu Tateishi
    • 2
  • Tomomi Endo
    • 1
  • Hiroyuki Suzuki
    • 1
  • Toshiro Katayama
    • 3
  • Tatsuo Tsukamoto
    • 1
  • Eri Muso
    • 1
    • 4
  1. 1.Division of Nephrology and Dialysis, Kitano HospitalThe Tazuke Kofukai Medical Research InstituteOsakaJapan
  2. 2.Division of NephrologyIshikiriseiki HospitalOsakaJapan
  3. 3.Faculty of Health Sciences, Department of Medical EngineeringHimeji Dokkyo UniversityHimejiJapan
  4. 4.Department of Diagnostic PathologyKyoto University HospitalKyotoJapan

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