Intensity of Macrophage Infiltration in Glomeruli Predicts Response to Immunosuppressive Therapy in Patients with IgA Nephropathy

作者：Di Xie, Hao Zhao, Xin Xu, Zhanmei Zhou, Cailing Su, Nan Jia, Youhua Liu, Fan Fan Hou · 发表于：Journal of the American Society of Nephrology · 年份：2021 · DOI：10.1681/asn.2021060815 · 被引用次数：65 · 研究领域：Renal Diseases and Glomerulopathies、Vasculitis and related conditions、Chronic Kidney Disease and Diabetes

Significance Statement The lack of a tool for predicting the response to immunosuppressive therapy in IgA nephropathy (IgAN) limits patient-specific risk stratification and early treatment decisions. To derive and validate the models for predicting response to immunosuppressive therapy in IgAN that can be applied at the time of kidney biopsy, the authors conducted a prospective cohort study of 621 Chinese patients with IgAN. Patients had persistent proteinuria of ≥1 g/d, despite 3 months of optimized supportive care with renin-angiotensin system inhibitors, and received immunosuppressive therapy. The authors used immunohistochemistry to identify cellular infiltrates in biopsy specimens and digital image analysis to quantify them. The intensity of glomerular macrophage infiltration, alone or combined with clinical and histologic data, accurately predicted the response to immunosuppression and, thus, may help physicians identify patients with IgAN who will benefit from immunosuppression. Background The lack of a tool for predicting the response to immunosuppressive therapy in IgA nephropathy (IgAN) limits patient-specific risk stratification and early treatment decision making. Models for predicting response to immunosuppression in IgAN that can be applied at the time of kidney biopsy are needed. Methods This prospective cohort study involved 621 Chinese patients with IgAN who were at high risk for disease progression and had persistent proteinuria ≥1 g/d, despite 3 months of o...