Skip to main content
SpringerLink
Log in

The role of urine IgG in the progression of IgA nephropathy with a high proportion of global glomerulosclerosis

  • Nephrology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Background

IgA nephropathy (IgAN), the most common glomerulonephritis in the world, is an important cause of end-stage renal disease (ESRD). It is necessary to explore new prognostic markers for predicting the activity and progress of IgAN. There are few studies on new prognostic markers in IgAN patients with high proportion of glomerulosclerosis. This study aims to explore the value of urine IgG in predicting the prognosis of IgAN patients.

Methods

The primary end point of this retrospective study was a composite event with a reduction in estimated glomerular filtration rate (eGFR) of  ≥ 50% or ESRD or death. This study assessed the association between urinary IgG and clinicopathological parameters, as well as the prognosis of a high proportion of patients with global glomerulosclerotic IgAN.

Results

This study included 105 IgAN patients with high proportion of global glomerulosclerotic. The level of urinary protein IgG was significantly correlated with clinical prognostic factors. The level of urinary protein IgG was positively correlated with urinary protein excretion (rs = 0.834, P < 0.001), CRP (rs = 0.375, P < 0.001), and C4 (rs = 0.228, P = 0.019), and negatively correlated with eGFR (rs =  – 0.307, P = 0.001). In addition, the level of urinary IgG increased with the increase of tubulointerstitial injury rate, which was positively correlated with endothelial cell proliferation and crescent (all P < 0.05). Prognostic analysis using the Cox proportional hazard regression model and Kaplan–Meier survival curve further determined that urine IgG is an independent risk factor for the prognosis of IgAN with high proportion of global glomerulosclerosis.

Conclusions

This study determined that urine IgG can be used as a useful predictor of the prognosis of IgAN patients with high proportion global glomerulosclerosis. The mechanism of urine IgG trends in IgAN with high proportion of glomerulosclerosis needs further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability statement

The data used to support the findings of this study are restricted by the Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine to protect the patient privacy. Data are available from Guangdong Provincial Hospital of Chinese Medicine for researchers who meet the criteria for access to confidential data.

References

  1. Roos A et al (2006) Glomerular activation of the lectin pathway of complement in IgA nephropathy is associated with more severe renal disease. J Am Soc Nephrol 17(6):1724–1734

    Article  CAS  Google Scholar 

  2. Cheung C, Bashir S, Barratt J (2014) IgA nephropathy. Br J Hosp Med (Lond) 75(Suppl 11):C173–C176

    Article  Google Scholar 

  3. D’Amico G (2000) Natural history of idiopathic IgA nephropathy: role of clinical and histological prognostic factors. Am J Kidney Dis 36(2):227–237

    Article  CAS  Google Scholar 

  4. Barbour SJ et al (2013) Individuals of Pacific Asian origin with IgA nephropathy have an increased risk of progression to end-stage renal disease. Kidney Int 84(5):1017–1024

    Article  CAS  Google Scholar 

  5. Knoop T et al (2017) Long-term outcome in 145 patients with assumed benign immunoglobulin A nephropathy. Nephrol Dial Transplant 32(11):1841–1850

    Article  CAS  Google Scholar 

  6. Walsh M et al (2010) Histopathologic features aid in predicting risk for progression of IgA nephropathy. Clin J Am Soc Nephrol CJASN 5(3):425–430

    Article  CAS  Google Scholar 

  7. Coppo R (2017) Clinical and histological risk factors for progression of IgA nephropathy: an update in children, young and adult patients. J Nephrol 30(3):339–346

    Article  CAS  Google Scholar 

  8. Wang J et al (2020) The role of hypertriglyceridemia and treatment patterns in the progression of IgA nephropathy with a high proportion of global glomerulosclerosis. Int Urol Nephrol 52(2):325–335

    Article  Google Scholar 

  9. Donadio JV et al (2002) Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy. Nephrol Dial Transplant 17(7):1197–1203

    Article  CAS  Google Scholar 

  10. Reich HN et al (2007) Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol 18(12):3177–3183

    Article  CAS  Google Scholar 

  11. Bazzi B et al (2009) In crescentic IgA nephropathy, fractional excretion of IgG in combination with nephron loss is the best predictor of progression and responsiveness to immunosuppression. Clin J Am Soc Nephrol 4(5):929–935

    Article  Google Scholar 

  12. Bazzi C et al (2001) Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy. Am J Kidney Dis 38(2):240–248

    Article  CAS  Google Scholar 

  13. Cattran DC et al (2009) The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int 76(5):534–545

    Article  Google Scholar 

  14. Trimarchi H et al (2017) Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int 91(5):1014–1021

    Article  Google Scholar 

  15. Branten AJ, du Buf-Vereijken PW, Klasen IS et al (2005) Urinary excretion of beta2-microglobulin and IgG predict prognosis in idiopathic membranous nephropathy: a validation study. J Am Soc Nephrol 16(1):169–174

    Article  CAS  Google Scholar 

  16. Reichert LJ, Koene RA, Wetzels JF (1997) Urinary IgG excretion as a prognostic factor in idiopathic membranous nephropathy. Clin Nephrol 48(2):79–84

    CAS  PubMed  Google Scholar 

  17. Gabay C, Kushner I (1999) Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 340(6):448–454

    Article  CAS  Google Scholar 

  18. Bi T et al (2019) Serum complement C4 is an important prognostic factor for IgA nephropathy: a retrospective study. BMC Nephrol 20(1):244

    Article  Google Scholar 

  19. Abbate M, Zoja C, Remuzzi G (2006) How does proteinuria cause progressive renal damage. J Am Soc Nephrol 17(11):2974–2984

    Article  CAS  Google Scholar 

  20. Morais C et al (2005) High molecular weight plasma proteins induce apoptosis and Fas/FasL expression in human proximal tubular cells. Nephrol Dial Transplant 20(1):50–58

    Article  CAS  Google Scholar 

  21. Berg UB, Bohman SO, Widstam-Attorps U (1991) Renal histological changes in relation to renal function and urinary protein excretion in IgA nephropathy. Arch Dis Child 66(5):593–597

    Article  CAS  Google Scholar 

  22. Tencer J, Bakoush O, Torffvit O (2000) Diagnostic and prognostic significance of proteinuria selectivity index in glomerular diseases. Clinica Chimica Acta Int J Clin Chem 297:73–83

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The study was funded by Research Project for Practice Development of National TCM Clinical Research Bases (Project no. JDZX2015202) and National Key R&D Program "Research on Modernization of Traditional Chinese Medicine" (Project no. 2019YFC1709903).

Author information

Author notes

  1. Xianqi Xu and Xiaodan Huang have contributed equally to this work.

Authors and Affiliations

  1. Shantou Hospital of Traditional Chinese Medicine, Shantou, 515000, Guangdong, China

    Xianqi Xu

  2. Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China

    Xiaodan Huang, Yizhen Chen, Jundu Li, Miaoying Shen, Yuansheng Hou & Xuefei Lin

  3. Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China

    Qizhan Lin, Xusheng Liu, Kun Bao, Lixin Wang, Lichang Liu & Chuan Zou

  4. Department of Pathology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, Guangdong, China

    Haifeng Yang

Authors
  1. Xianqi Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiaodan Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yizhen Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jundu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miaoying Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuansheng Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xuefei Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Qizhan Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xusheng Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kun Bao
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Lixin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Haifeng Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lichang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Chuan Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Research idea, study design, article writing, and guidance on revision: CZ; article writing and revision: XX; article revision and submission: XH; data collection, collation, and summary: YC, JL, MS, YH, and XL; provide medical records and renal biopsy specimens: QL, XL, KB, LW, and LL; pathological diagnosis: HY.

Corresponding authors

Correspondence to Qizhan Lin or Chuan Zou.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflicts of interest that may influence the results.

Ethical approval

The study was approved by the Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, X., Huang, X., Chen, Y. et al. The role of urine IgG in the progression of IgA nephropathy with a high proportion of global glomerulosclerosis. Int Urol Nephrol 54, 323–330 (2022). https://doi.org/10.1007/s11255-021-02858-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-021-02858-y

Keywords

Search

Navigation