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2015 ; 10
(9
): e0137870
Nephropedia Template TP
gab.com Text
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English Wikipedia
Association of Relapse with Renal Outcomes under the Current Therapy Regimen for
IgA Nephropathy: A Multi-Center Study
#MMPMID26371477
Yuan Y
; Che X
; Ni Z
; Zhong Y
; Qi Y
; Shao X
; Wang Q
; Cao L
; Zhang M
; Xie Y
; Qi C
; Tian L
; Mou S
PLoS One
2015[]; 10
(9
): e0137870
PMID26371477
show ga
BACKGROUND AND OBJECTIVES: Renal relapse is a very common manifestation of IgA
nephropathy (IgAN). The clinical characteristics and long-term outcomes of this
condition have not yet been carefully explored. DESIGN AND PATIENTS: Patients
with biopsy-proven IgAN between January 2005 and December 2010 from three medical
centers in China was a primary cohort of patients. From January 2010 to April
2012, data of an independent cohort of IgAN patients from Ren Ji Hospital,
Shanghai, China was collected using the same inclusion and exclusion criteria.
These patients formed the validation cohort of this study. RESULTS: Of the
patients with biopsy-proven IgAN from three medical centers, 489 patients
achieved remission within 6 months following the therapy. Additionally, 76
(15.5%) of these patients experienced a relapse after achieving remission. During
the median follow-up period of 66 months, 6 patients (1.4%) in the non-relapse
group experienced renal deterioration, compared with 22 patients (29.6%) in the
relapse group. Our study indicated that each 1-mmHg increase in the baseline
diastolic blood pressure (DBP) was associated with a 4.5% increase in the risk of
renal relapse; additionally, the male patients had a 3.324-fold greater risk of
relapse compared with the female patients according to the adjusted multivariate
Cox analysis. The nomogram was based on 489 patients achieved remission. The
predictive accuracy and discriminative ability of the nomogram were determined by
concordance index (C-index) and calibration curve. The results were validated
using bootstrap resampling on the validation cohort. CONCLUSIONS: This study
demonstrated that renal relapse is a potential predictor of prognostic outcomes
in patients under the current therapeutic regimens for IgAN. And male patients
with higher diastolic blood pressure had a greater risk of experiencing relapse.