Correlation Study Between Serum IgG And Adverse Prognosis Of IgA Nephropathy

Objective:To investigate the relationship between serum IgG and IgA nephropathy with poor prognosis.Methods:A retrospective analysis was made on 220 patients with IgAN diagnosed by renal biopsy from July 2015 to August 2018 in our hospital.The endpoint event was end-stage renal disease[eGFR<15ml/(min·1.73m~2)]or an 50%eGFR reduction at least.The clinical and pathological data were collected to analyze the factors influencing the deterioration of IgAN.Then All subjects were divided into four groups according to the level of serum IgG.The clinical and pathological indexes at baseline and the cumulative renal survival rates during follow-up were compared.Results:1.There were statistically significant differences in systolic blood pressure,diastolic blood pressure,serum IgG,C3,serum creatinine,eGFR,serum albumin and24-hour urinary protein among the deterioration and non deterioration groups(P<0.05).2.Multivariate Logistic regression analysis showed that eGFR and serum albumin at baseline were protective factors for the deterioration of IgAN,and 24-hour urinary protein was a risk factor for the deterioration of IgAN(P<0.05).3.There were statistically significant differences in systolic blood pressure,diastolic blood pressure,serum IgM,serum albumin and 24-hour urinary protein among the four groups of serum IgG,and there were statistically significant differences in the Oxford Classification M among the four groups(P<0.05).2.All patients were followed for a median of 399 days,and 26%、13.46%、18.97%、5%of the patients in the serum IgG concentration subgroups 1,2,3 and 4,respectively,reached the endpoint in the first year.Multivariate Logistic regression analysis showed that the cumulative renal survival rate of patients with IgG≥12.28g/l was higher than that of other three groups(P=0.045).Conclusion:The eGFR and serum albumin at baseline were protective factors for the deterioration of IgAN,and 24-hour urinary protein was a risk factor for the deterioration of IgAN.Decreased serum IgG may indicate a poor prognosis in IgAN.