Lupus Nephritis With Obvious IgA Deposits in the Kidneys

Am J Med Sci. 2022 Feb;363(2):174-184. doi: 10.1016/j.amjms.2020.11.032. Epub 2021 Jul 29.

Abstract

Background: The purpose of the current study was to describe the clinico-pathological characteristics and outcomes in patients with lupus nephritis with IgA deposits in the kidneys.

Methods: A total of 258 patients with lupus nephritis with complete clinical data and follow-up was enrolled. They were divided into two groups: the IgA deposits group and the non-IgA deposits group. Their clinico-pathological features and outcomes between the two groups were further compared.

Results: Patients with IgA deposits had significantly lower prevalence of acute kidney failure, higher eGFR, lower plasma levels of C3a, and lower renal pathological chronicity indices scores than those with non-IgA deposits (19.4% vs. 31.8%, 86.2 [52.8, 110.7] vs. 77.6 [32.2, 101.7] ml/min/1.73m2, 1045.48 [559.41, 1796.34] vs. 1920.77 [1155.08, 2986.96]ng/ml, and 2 [1, 3] vs. 2.5 [2, 4], respectively, all P < 0.05). Patients with IgA deposits also had a higher frequency of the CFH rs6677604-AA/GA genotype in comparison with those with non-IgA deposits (12.0% vs. 8.2%, P = 0.469). Using the multivariable Cox hazard analysis, the IgA deposits were identified as a protective factor of survival from the composite events (HR 0.423; 95% CI, 0.219 to 0.816; P = 0.01).

Conclusions: Patients with IgA deposits presented with milder renal damage and a good prognosis, which suggested its protective role in lupus nephritis.

Keywords: IgA deposits; Lupus nephritis; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Humans
  • Immunoglobulin A
  • Kidney / pathology
  • Lupus Nephritis* / complications
  • Lupus Nephritis* / epidemiology
  • Male

Substances

  • Immunoglobulin A