Noninvasive Diagnosis Of IgA Nephropathy And Evaluation Of Serological Indicators Related To Pathological Damage

Objective:By analyzing the clinical data of patients with Ig A nephropathy(IgAN),looking for relevant indicators for non-invasive diagnosis of IgAN,exploring the efficacy of single test and multiple combined tests,and predicting the pathological damage of the disease.Methods:A total of 443 patients with primary glomerulonephritis who were diagnosed with IgAN(n = 143) and non-IgAN(n = 300)for the first time in the Department of Nephrology,Jilin University First Hospital from 2017 to 2019 were collected.The pathological grading method was used to classify the degree of renal pathological damage.The clinical data were analyzed retrospectively,the data was analyzed using SPSS26.0 statistical software,the receiver operating characteristic curve(ROC)analysis was used to evaluate the diagnostic value of clinical factors,and the multivariate analysis was tested using binary logistic regression analysis.Results:Combining the results of the full cohort,we found that urine red blood cell counts,proteinuria,creatinine,albumin,Ig A,Ig A/C3,cystatin C,and Ig G were higher in IgAN patients than in non-IgAN patients.LDL is lower than in non-IgAN patients.Age,urinary red blood cell count,albumin,Ig A/C3,hemoglobin,cystatin C,triglyceride,HDL were independent risk factors for IgAN.ROC curve analysis showed that the AUC of age,24 h urinary protein,albumin,cholesterol,LDL,Ig A,Ig G,Ig A / C3,and e GFR was>0.700,which has diagnostic value for IgAN.The combined diagnosis(urinary red blood cell count,albumin,Ig A/C3,and cystatin C)had an AUC value of 0.922,a sensitivity of 86.01%,and a specificity of 89.33%.The diagnostic efficacy of combined diagnosis is higher than that of single diagnosis,and there is no difference in diagnostic significance between the CKD groups(P>0.05).The difference between proteinuria ? 1.0g/d and proteinuria>3.5g/d is statistically significant(P<0.05);IgAN patients were classified into light and heavy according to LEE's pathological classification method,and the blood pressure,proteinuria level,creatinine,urea nitrogen,cystatin C,retinol binding protein,blood The deposition of uric acid,e GFR,and C3 was slightly increased(P<0.05).The level of Ig A/C3 in the serum of IgAN patients can reflect the degree of Ig A and C3 deposition in the mesangial region,that is,the higher the level of Ig A/C3,the heavier the deposition of Ig A and C3 in the mesangial region to determine the immune complex the degree of material deposition,the degree of kidney damage.Conclusion:Establishing a comprehensive multifactorial(urinary red blood cell count,albumin,Ig A/C3,cystatin C)combined diagnosis can effectively distinguish between IgAN patients and non-IgAN patients,with high sensitivity and specificity.Serum Ig A/C3 level can assess the degree of Ig A and C3 immunofluorescence of IgAN glomerular mesangial area.The degree of C3 immunofluorescence can speculate the severity of renal pathological damage.