Gender-related differences in clinicopathological characteristics and renal outcomes of Chinese patients with IgA nephropathy

Deng, Wei; Tan, Xiaojie; Zhou, Qian; Ai, Zhen; Liu, Wenting; Chen, Wei; Yu, Xueqing; Yang, Qiongqiong

doi:10.1186/s12882-018-0829-1

Cited by 31 publications

(36 citation statements)

References 27 publications

(39 reference statements)

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“…Furthermore, all 4 patients demonstrating disease progression over the course of the 2-year follow-up were male. According to Deng et al [50], although female preponderance was evident in IgA nephropathy, male IgA patients presented with worse clinicopathologic features than female patients and higher rates of creatinine increase, which could support our result. Further research should be performed to investigate the impact of gender in IgA nephropathy prognosis.…”

Section: Discussionsupporting

confidence: 82%

Serum miR-192 Is Related to Tubulointerstitial Lesion and Short-Term Disease Progression in IgA Nephropathy

Fan

Zhu

et al. 2019

Nephron

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Background/Aims: Clinical manifestation and renal histology serve as the current “gold standard” for evaluation of renal lesions in IgA nephropathy. MiR-192 is regarded as a potential noninvasive biomarker for kidney disease. We sought to elucidate a relationship between intrarenal, serum, and urinary exosomal miR-192 with renal lesions and disease progression in IgA nephropathy. Methods: Serum and urinary exosomal miR-192 were detected and correlated with clinical and pathological parameters from consecutive IgA nephropathy patients (n = 50) and healthy control patients (n = 25). Patients then received a follow-up of 24 months after biopsy. Disease progression was defined as a 40% reduction in estimated glomerular filtration rate. Expression of miR-192 was quantified by Taqman RT-PCR. Intrarenal miR-192 was detected in 8 IgA nephropathy patients and 4 matched patients receiving kidney nephrectomy as controls via in situ hybridization. TGF-β1 and E-cadherin expression in renal tissue was evaluated using immunohistochemistry. Results: Intrarenal miR-192 was correlated with serum miR-192 (r = 0.690, p = 0.013). Both intrarenal and serum miR-192 decreased in IgA nephropathy patients and were correlated with estimated glomerular filtration ratio. Patients with lower intrarenal and serum miR-192 levels had a higher interstitial fibrosis and tubular atrophy score, more severe lesions in tubular atrophy, and interstitial inflammation. Renal E-cadherin expression was correlated (r = 0.484, p = 0.004) and TGF-β1 was inversely correlated (r = –0.527, p < 0.001) with serum miR-192 in IgA. Patients with higher serum miR-192 had a lower disease progression rate over the course of 2 years (0 vs. 16%, p = 0.028). No correlation was found in urinary exosomal miR-192 with the clinical and pathological parameters mentioned earlier. Conclusions: Lower serum miR-192 in IgA nephropathy patients indicates lower intrarenal miR-192 expression, more severe tubular atrophy, interstitial inflammation, and fibrotic tendency (with higher TGF-β and E-cadherin in renal miR-192). IgA nephropathy patients with higher serum miR-192 are less likely to have renal function decline over the course of 2 years.

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Section: Discussionsupporting

confidence: 82%

Serum miR-192 Is Related to Tubulointerstitial Lesion and Short-Term Disease Progression in IgA Nephropathy

Fan

Zhu

et al. 2019

Nephron

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“…Similar result was obtained in an investigation including 24.886 elderly residents in a community [10]. A retrospective study of IgAN patients showed no significant differences observed in renal survival between male and female by SUA level-matching [30]. Another single-center retrospective cohort study showed that an elevated uric acid level was an independent risk factor for ESKD in female IgA patients but not male patients [5].…”

Section: Discussionsupporting

confidence: 75%

Gender-specific association between uric acid level and chronic kidney disease in the elderly health checkup population in China

Yang

Zhou²,

Wang

et al. 2019

Renal Failure

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Objective : To evaluate the association between serum uric acid (SUA) levels with CKD in elderly health checkup population and explore the gender difference. Methods: A total of 4242 subjects were included in the cross-sectional study. All of the subjects participated in the annual checkup between June 2016 and June 2017. Chronic kidney disease (CKD) was defined by estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m 2 . We examined the association between SUA levels and CKD. Multivariate binary logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) by comparing association between the SUA level and CKD. The models were adjusted for age, gender, body mass index (BMI), hypertension, diabetes, triglyceride and high-density lipoprotein cholesterol (HDL-C). Result: The prevalence of hyperuricemia was 22.2%, and it was significantly higher in male than in female (25.2% vs. 17%, p < .001). The prevalence of hyperuricemia increased with age, especially in the female. The prevalence of CKD was 27.8% in male and 20.2% in female ( p < .001). Compared with the SUA first quartile, the multivariate-adjusted odds for CKD of fourth quartiles were 6.05 (95%CI: 4.32–8.49) in male and 8.21(95%CI: 5.37–12.54) in female. Conclusion: Our finding showed gender-specific differences in the association between high SUA and an increased risk of CKD in the elderly population. The association of SUA and CKD was independent of other potential confounding factors including age, glucose, hypertension, HDL, TG and BMI.

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“…23,24 Consistent with European studies, males predominated (male : female, 2.4:1) in GRACE-IgANI, which is distinct from East Asian cohorts which report either equal incidence in males and females or even an increased frequency in females. [25][26][27][28] Similar to studies reported from China, at presentation males had more advanced disease with lower eGFR, more frequent hypertension and more fibrosis on kidney biopsy. 26 A metaanalysis of 25 studies in IgAN reported that male gender was associated with a worse outcome.…”

Section: Baseline Risk Of Progression In the Grace-igani Cohort Usingsupporting

confidence: 75%

“…[25][26][27][28] Similar to studies reported from China, at presentation males had more advanced disease with lower eGFR, more frequent hypertension and more fibrosis on kidney biopsy. 26 A metaanalysis of 25 studies in IgAN reported that male gender was associated with a worse outcome. 29 GRACE-IgANI will allow us to determine if this is true of South Asian males with longitudinal follow-up data.…”

Section: Baseline Risk Of Progression In the Grace-igani Cohort Usingsupporting

confidence: 75%

Epidemiology, baseline characteristics and risk of progression in the first South-Asian prospective longitudinal observational IgA nephropathy cohort

Schmeißer

Varughese

Franklin

et al. 2021

Kidney International Reports

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Introduction Glomerular Research And Clinical Experiments–IgA Nephropathy in Indians (GRACE-IgANI) is the first prospective South Asian IgAN cohort with protocolized follow-up and extensive biosample collection. Here we report the baseline clinical, biochemical, and histopathologic characteristics of GRACE IgANI and calculate baseline risk of progression for the cohort. Methods 201 incident adults with kidney biopsy–proven primary IgAN were recruited into GRACE-IgANI between March 2015 and September 2017. As of April 30, 2020, the cohort had completed a median follow-up of 30 months (interquartile range [IQR] 16-39). Results The commonest clinical presentation in GRACE IgANI was hypertension, with or without proteinuria, and nephrotic-range proteinuria was present in 34%, despite <10 months of lead time to kidney biopsy. The GRACE-IgANI kidney biopsy data demonstrated a disproportionate absence of active glomerular lesions and overrepresentation of segmental sclerosing lesions and tubulointerstitial fibrosis at presentation, often coexistent with relatively well-preserved estimated glomerular filtration rate (eGFR) and low levels of proteinuria, especially in males. Baseline risk of progression was calculated for each evaluable patient using 2 different risk prediction tools. The median 5-year absolute risk of end-stage kidney disease (ESKD) was 19.8% (IQR 2.7–57.4) and median 5-year risk of progression to the combined endpoint of 50% decline in eGFR or ESKD was 35.5% using the 2 tools. Conclusions The predicted risk of progression in this cohort was considerable. Over the next 5 years, we will dissect the pathogenic pathways that underlie this severe South Asian IgAN phenotype.

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Gender-related differences in clinicopathological characteristics and renal outcomes of Chinese patients with IgA nephropathy

Cited by 31 publications

References 27 publications

Serum miR-192 Is Related to Tubulointerstitial Lesion and Short-Term Disease Progression in IgA Nephropathy

Serum miR-192 Is Related to Tubulointerstitial Lesion and Short-Term Disease Progression in IgA Nephropathy

Gender-specific association between uric acid level and chronic kidney disease in the elderly health checkup population in China

Epidemiology, baseline characteristics and risk of progression in the first South-Asian prospective longitudinal observational IgA nephropathy cohort

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