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Open Access Highly Accessed Research article

Glomerular tip adhesions predict the progression of IgA nephropathy

Kunihiro Maeda1, Shogo Kikuchi2, Naoto Miura1, Keisuke Suzuki1, Wataru Kitagawa1, Hiroyuki Morita1, Shogo Banno1 and Hirokazu Imai1*

Author Affiliations

1 Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi 480-1195, Japan

2 Department of Public Health, Aichi Medical University School of Medicine, Aichi 480-1195, Japan

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BMC Nephrology 2013, 14:272  doi:10.1186/1471-2369-14-272

Published: 5 December 2013

Abstract

Background

Focal segmental glomerulosclerosis-like lesions have been proposed to be predictive factors for IgA nephropathy. This single center, retrospective cohort study was designed to clarify which clinical and pathological factors are predictive of decreased estimated glomerular filtration rate (eGFR) at 5 and 10 years in IgA nephropathy patients.

Methods

Of the 229 patients with IgA nephropathy who were admitted to Aichi Medical University Hospital between 1986 and 2010, 57 were included in this study during the 5 to 10 years after renal biopsy. Clinical, laboratory, and pathological parameters were analyzed by multiple linear regression analysis with backward elimination to determine independent risk factors. After identifying such factors, we compared patients with and without each factor using the Student’s t test, Wilcoxon test, or Mann–Whitney U test.

Results

Four variables were identified as predictive factors for progression of IgA nephropathy: initial eGFR (p = 0.0002), glomerular tip adhesion (p = 0.004), global sclerosis (p = 0.019), and diastolic blood pressure (p = 0.024). The annual decrease in eGFR of patients with (n = 9) or without glomerular tip adhesions (n = 48) was 4.13 ± 3.58 and 1.49 ± 2.89 ml/min/1.73 m2, respectively (p = 0.015). Serum total cholesterol levels were 231 ± 45 mg/dl and 196 ± 42 mg/dl, respectively (two-sided p = 0.064; one-sided p = 0.032).

Conclusions

The presence of glomerular tip adhesions predicts the progression of IgA nephropathy. High levels of serum total cholesterol may affect glomerular tip adhesions.