Renal Interstitial Inflammation Predicts Nephropathy Progression in IgA Nephropathy: A Two-Center Cohort Study

作者：Bin Zhu, Wenhua Liu, Yi Lin, Qiang Li, Dongrong Yu, Fei Jiang, Xuanli Tang, Yuanyuan Du, Jiazhen Yin, Xianfa Li, Yongzhong Zhong, Wenrong Wang, Yue Sun, Mei-Juan Zhang, Yuancheng Gao, Chen-Yi Yuan, Caifeng Zhu, Xiaoxia Cheng · 发表于：American Journal of Nephrology · 年份：2022 · DOI：10.1159/000524585 · 被引用次数：12 · 研究领域：Renal Diseases and Glomerulopathies、Chronic Kidney Disease and Diabetes、Nephrotoxicity and Medicinal Plants

INTRODUCTION: Renal interstitial inflammation often presents in immunoglobulin A nephropathy (IgAN), but its predictive role in kidney disease progression remains controversial. METHODS: This retrospective two-center cohort study included 1,420 adult IgAN patients between January 2003 and May 2018 followed for a median of approximately 7 years at two Chinese hospitals. The predictor was renal interstitial inflammation within the total cortical interstitium (none/mild [0-25%], moderate [26-50%], or severe [>50%]). For the further propensity score matching analyses, the participants with moderate and severe level of interstitial inflammation were pooled to match those with none/mild level of interstitial inflammation. The outcomes included the rate of kidney function decline, and the composite kidney endpoint event defined as a >40% reduction in the estimated glomerular filtration rate, end-stage kidney disease. Linear regression and Cox proportional hazards regression analyses were used to examine the association between interstitial inflammation and the outcomes. The predictive performance of the model also assessed using multivariate logistic regression analyses with the receiver operating characteristic curve analysis. Reclassification was assessed using the continuous net reclassification improvement and integrated discrimination improvement adapted for censoring for the assessment of the model with or without interstitial inflammation. RESULTS: For the check of reproducib...