Abstract
BackgroundIgA nephropathy is a primary cause of renal failure, and inflammation and renal fibrosis are the main mechanisms leading to kidney damage. The serum fibrinogen level is closely related to inflammatory states, but its relationship to the prognosis of IgA nephropathy (IgAN) is unclear.Materials and Methods1053 patients diagnosed with IgAN after renal biopsy were enrolled from two Nephrology Departments. Demographic and clinical data and histopathological features were collected. The patients were divided into four groups (Q1–Q4) according to the serum fibrinogen levels at the time of renal biopsy, and the relationships of serum fibrinogen levels with other risk factors and the prognosis of IgAN were investigated.Results672 patients with proven primary IgAN were included in this study, which included a median follow-up of 36 months. Patients with higher serum fibrinogen levels had elevated serum creatinine levels, 24-hour urinary protein, and blood pressure compared with patients with the lowest levels of serum fibrinogen as well as severe renal damage at the time of renal biopsy. Univariate and multivariate Cox regression analyses confirmed that the serum fibrinogen level at the time of renal biopsy was significantly related to the prognosis of patients with IgAN.ConclusionsIn patients with IgAN, an elevated serum fibrinogen level at the time of renal biopsy is associated with poor renal outcomes, which suggests the need for more aggressive early interventions. Greater benefits of aggressive treatments were observed in patients with higher serum fibrinogen levels.
Highlights
IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide and is characterized by the deposition of IgA in the glomerular mesangium
IgA nephropathy is a primary cause of renal failure, and inflammation and renal fibrosis are the main mechanisms leading to kidney damage
Univariate and multivariate Cox regression analyses confirmed that the serum fibrinogen level at the time of renal biopsy was significantly related to the prognosis of patients with IgAN
Summary
IgA nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide and is characterized by the deposition of IgA in the glomerular mesangium. One-third of patients with IgAN develop end-stage renal disease within 20–30 years after their initial diagnosis [1]. Nephrologists find it challenging to predict the prognosis of and identify appropriate treatment options for patients with IgAN. IgAN is considered an autoimmune disease and is accompanied by inflammatory activity [5] These traditional indicators do not directly reflect the patient’s inflammatory status, and the roles of inflammatory factors in the prognosis and determination of treatment options are unclear. The serum fibrinogen level is closely related to inflammatory states, but its relationship to the prognosis of IgA nephropathy (IgAN) is unclear
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