Elevated Serum Chloride Level Contributes to the Poor Prognosis of IgA Nephropathy

Abstract

IntroductionFinding reliable prognostic factors is crucial for IgA nephropathy (IgAN). Here, we determined the relationship between prognosis of IgAN with serum chloride.MethodsPrimary IgAN diagnosed by renal biopsy from January 1, 2015 to April 1, 2019 were recruited. Patients were divided into lower group and higher group based on the best cut-off value of survival receiver operating characteristics (ROC) curves. The baseline clinicopathological characteristics were retrospectively compared. Cox proportional hazard models were used to demonstrate the prognostic value of serum chloride in IgAN. Prognosis prediction model was built by multivariate Cox regression. ResultsCompared to higher group , age、24-hour urinary protein and serum creatinine(Cr) in the lower group were significantly lower, hemoglobin(Hb)、albumin were significantly higher(all P<0.05),the degree of endothelial cell proliferation (E) and renal tubule atrophy or renal interstitial fibrosis (T) were significantly lighter (all P<0.05). Univariate and multivariate Cox analysis revealed that serum chloride ≥105.4 mmol/l was an independent risk factor for the prognosis of IgAN(P<0.05). Serum chloride, Cr, T, hypertension, and Hb were screened out as features in predictive prognosis model. The c-index of the model was 0.85、0.82 and 0.77 for 1、2 and 3 years respectively, and brier scores were 0.06 、0.09 and 0.16 respectively. ConclusionsSerum chloride ≥105.4 mmol/l was an independent risk factor for the prognosis of IgAN. A predictive prognosis model including serum chloride, Cr, T, hypertension and Hb exhibited a relatively good prediction effect.