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Glomerular IgG deposition predicts renal outcome in patients with IgA nephropathy

 Dong Ho Shin  ;  Beom Jin Lim  ;  In Mi Han  ;  Seung Gyu Han  ;  Young Eun Kwon  ;  Kyoung Sook Park  ;  Mi Jung Lee  ;  Hyung Jung Oh  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Shin-Wook Kang  ;  Tae-Hyun Yoo 
 Modern Pathology, Vol.29(7) : 743-752, 2016 
Journal Title
 Modern Pathology 
Issue Date
Adult ; Arterial Pressure/physiology ; Disease Progression ; Female ; Glomerular Filtration Rate/physiology ; Glomerulonephritis, IGA/metabolism ; Glomerulonephritis, IGA/pathology* ; Glomerulonephritis, IGA/physiopathology ; Humans ; Immunoglobulin G/metabolism* ; Kidney/metabolism ; Kidney/pathology* ; Kidney/physiopathology ; Kidney Failure, Chronic/metabolism ; Kidney Failure, Chronic/pathology* ; Kidney Failure, Chronic/physiopathology ; Kidney Glomerulus/metabolism ; Kidney Glomerulus/pathology* ; Kidney Glomerulus/physiopathology ; Male ; Prognosis
Glomerular IgG deposition is frequently observed in patients with IgA nephropathy. However, the association between glomerular IgG deposition and progression of IgA nephropathy is uncertain. Six hundred and twenty-seven patients with biopsy-proven IgA nephropathy were recruited. Histological variables of the Oxford classification (Oxford-MEST) and the presence of glomerular IgG deposits were assessed. Renal progression defined as end-stage renal disease or 50% reduction in estimated glomerular filtration rate was analyzed using Kaplan-Meier methods and Cox regression analysis. Of the study population, 200 patients (31.9%) had glomerular IgG deposition on immunofluorescence staining. During a mean follow-up of 56.8±37.5 months, the rate of renal progression was significantly higher in the IgA nephropathy patients with glomerular IgG deposition compared with the IgA nephropathy patients without glomerular IgG deposition (39.8 vs 12.3 per 1000 patient-years; P<0.001). Of patients with IgG deposition, 178 (28.3%), 20 (3.2%), and 2 (0.3%) patients had mild, moderate, and marked glomerular IgG deposits, receptively. Kaplan-Meier analysis revealed that cumulative renal survival was significantly lower in IgA nephropathy patients with the higher intensity of glomerular IgG deposits (P<0.001). In addition, Cox regression analysis revealed that moderate and marked glomerular IgG deposits significantly predicted renal outcome independent of Oxford-MEST and clinical variables (HR, 2.97; 95% CI, 1.01-8.77; P=0.04). This study showed that that glomerular IgG deposition was independently associated with poor renal outcome in patient with IgA nephropathy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
강신욱(Kang, Shin Wook) ORCID logo https://orcid.org/0000-0002-5677-4756
권영은(Kwon, Young Eun)
박정탁(Park, Jung Tak) ORCID logo https://orcid.org/0000-0002-2325-8982
유태현(Yoo, Tae Hyun) ORCID logo https://orcid.org/0000-0002-9183-4507
임범진(Lim, Beom Jin) ORCID logo https://orcid.org/0000-0003-2856-0133
한승혁(Han, Seung Hyeok) ORCID logo https://orcid.org/0000-0001-7923-5635
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