| Background:IgA nephropathy is a common pathological type of primary glomerulonephritis, a high incidence of20-40%of patients eventually enter ESRD, thus it’s important to identify risk factors of IgA nephropathy, and to give early intervention. Studies have shown expression of VEGF, VEGFR-1and VEGFR-2varies in different types of nephropathy such as minimal change nephropathy, membranous nephropathy, lupus nephritis, diabetic nephropathy and other diseases. The expression plays a role in the prognosis of these diseases.Objective:To investigate the expression of VEGF, VEGFR-1, VEGFR-2in kidneys of IgA nephropathy patients, and to find out whether the expression affects the remission of proteinuria in IgA nephropathy patients.Methods:We chose a total of49cases that were diagnosed as IgA nephropathy in Shandong Provincial Hospital after renal biopsy, took record of the patient’s age, sex, weight, blood pressure,24-hour urine protein excretion, serum albumin, blood lipids, serum creatinine, serum IgA, C3and uric acid level, made regular follow-up for at least1year We detected the expression of VEGF, VEGFR-1and VEGFR-2in glomerulus, tubules, interstitial sites of renal biopsy tissues by immunohistochemistry and ask two professional pathologists to score the expression level. The patients were divided into different groups according to their24-hour urinary protein excretion or pathological lesions. T tests was used to compare expression of VEGF, VEGFR-1, and VEGFR-2in both groups. Then the logistic regression was used to analysis whether related factors (such as:age, sex, urinary protein excretion, serum albumin, serum creatinine, serum levels of IgA and C3, serum levels of uric acid,histological type,treatment, etc.) affect remission of proteinuria in the patients.Results:1.Grouped according to the24-hour urinary protein excretion, the expression levels of VEGFR-2in group C (24-hour urine protein excretion≥3.5g) were significantly higher than in group B(24-hour urinary protein excretion ranged from1.Og to3.5g)(8.37±5.36VS4.78±4.27), P0.035; the expression levels of VEGFR-2in tubulointerstitial sites was significantly different between group B and group C (4.12±3.05VS2.36±2.03, P=0.012).The expression of VEGF and VEGFR-1showed no significant differences (P>0.05)in the other groups.2. VEGF expression levels were higher in samples with severe tubulointerstitial lesions (8.43±4.72VS4.98±4.11, P=0.040); while no significant differences were showed in the expression of VEGFR-1and VEGFR-2.3. VEGF expression levels were lower in samples with crescent formation (3.00±2.68VS5.81±4.41); VEGFR-2expression levels were lower in samples with crescent formation (1.80±1.30VS6.59±5.23, P=0.049). No significant differences were showed in the expression of VEGFR-14. Logistic regression analysis showed that VEGF expression in the renal samples of patients played a role in the remission of proteinuria, the higher the level of VEGF expression, the worse the remission. Age, diastolic blood pressure and cholesterol level were proved risk factors of the remission of proteinuria of IgA nephropathy.Conclusion:VEGF and VEGFR-2mainly expressed highly in tubulointerstitial sites in IgA nephropathy and closely associated with proteinuria outcomes, suggesting VEGF/VEGFR-2may be an important factor in the prognosis of IgA nephropathy. |
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