Version 1
: Received: 10 December 2023 / Approved: 11 December 2023 / Online: 12 December 2023 (07:35:50 CET)
How to cite:
Muzhetskaya, T.; Bogdanova, E.; Kochoyan, Z.; Dobronravov, V. IGA‐Nephropathy in Northeastern Europe: Clinical and Morphological Presentation and Outcomes. Preprints2023, 2023120699. https://doi.org/10.20944/preprints202312.0699.v1
Muzhetskaya, T.; Bogdanova, E.; Kochoyan, Z.; Dobronravov, V. IGA‐Nephropathy in Northeastern Europe: Clinical and Morphological Presentation and Outcomes. Preprints 2023, 2023120699. https://doi.org/10.20944/preprints202312.0699.v1
Muzhetskaya, T.; Bogdanova, E.; Kochoyan, Z.; Dobronravov, V. IGA‐Nephropathy in Northeastern Europe: Clinical and Morphological Presentation and Outcomes. Preprints2023, 2023120699. https://doi.org/10.20944/preprints202312.0699.v1
APA Style
Muzhetskaya, T., Bogdanova, E., Kochoyan, Z., & Dobronravov, V. (2023). IGA‐Nephropathy in Northeastern Europe: Clinical and Morphological Presentation and Outcomes. Preprints. https://doi.org/10.20944/preprints202312.0699.v1
Chicago/Turabian Style
Muzhetskaya, T., Zinaida Kochoyan and Vladimir Dobronravov. 2023 "IGA‐Nephropathy in Northeastern Europe: Clinical and Morphological Presentation and Outcomes" Preprints. https://doi.org/10.20944/preprints202312.0699.v1
Abstract
Aim. The analysis of incidence, clinical and morphological manifestations, and the prognosis of IgA nephropathy in the Northeastern Europe (NEE). Materials and methods. We enrolled cases with primary IgA nephropathy (IgAN) from 2005 to 2020 in the single-center retrospective study. Demographic and clinical parameters, histology data, and the treatment were analyzed. The outcomes were the occurrence of complete (PR) or partial remission (CR), renal replacement therapy (RRT), eGFR<15 ml/min/1.73m2 and eGFR decrease ≥ 50%. The composite endpoint included all renal outcomes and was used to evaluate the risk of IgAN progression and associated factors. Results. The incidence of IgAN cases was 23.6% of all indication biopsies and 41.2% of primary immune glomerulopathies. At the time of the kidney biopsy, the proteinuria was 2.5 (1.5-5.0) g/24h, eGFR - 69 ± 32 ml/min/1.73 m2. Proportions of cases with arterial hypertension and eGFR <60 ml / min / 1.73 m2 were 75% and 36%, respectively. The prevalence of histological changes in accordance with the Oxford (MEST-C) classification was M1 - 40.5%, E1 -22.9%, S1-70.2%, T1-22%, T2 - 9%, C1-16.7%, C2 - 4.4%. In the follow-up of 27 (11; 61) months, 6 deaths occured (1.7%). The 10-year cumulative dialysis-free survival was 80% and progression-free survival was 56%. Remissions registered in 50% of cases, being more frequent in patients who received immunosuppression vs renoprotection (60% vs. 40%, p = 0.001). In multivariable Cox regression, the independent factors associated with the increased probability of IgAN progression were male gender, a younger age, higher blood pressure and hematuria, lower eGFR, interstitial fibrosis/ tubular atrophy (≥50%), the presence of peritubular capillaritis and any crescents. Compared to the cohorts of other ethnic or geographical origin, IgAN in the studied cohort were found to have more severe clinical and morphological presentations and faster progression rate. Conclusion. Being the most common glomerulopathy in the NEE population, IgAN has more pronounced clinical and morphological presentations. Considering the distinctive features of the disease, further research is warranted in order to establish approaches for enhancing risk stratification and treatment efficacy.
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
