Charlotte Robinson

DocwireNews

Glomerular IgM deposit has been found in 25% to 80% of patients with IgA nephropathy (IgAN), but its potential impact on the progression of IgAN is unclear. To address this knowledge gap, Ziyuan Huang and others conducted a retrospective study of patients with biopsy-proven IgAN in a Chinese hospital from January 2018 to May 2023. Their findings were published in the journal Renal Failure.The study recruited 982 patients; 539 (54.9%) had positive glomerular IgM deposits in their renal immunofluorescence (IF) and were included in the IgM+ cohort. Patients with negative IgM deposit&nbsp;were included in the IgM&minus; cohort. The IgM+ patients were further divided into an IgM-H cohort of patients whose IF intensity of IgM deposits was greater than 1+, and an IgM-L cohort if their IF intensity of IgM deposits equaled 1+. Propensity score matching was used to make pairwise comparisons across the cohorts to evaluate clinical disparities.The composite end point was a sustained decline in estimated glomerular filtration rate from a baseline &ge;50% or reaching end-stage renal disease. A Kaplan-Meier analysis found that IgM deposit did not negatively affect these outcomes. Cox regression analysis, however, determined that increased intensity of IgM deposit was an independent risk factor in IgM+ (P=.03). Meanwhile, the IgM-H cohort demonstrated more pronounced segmental glomerulosclerosis (P=.02) versus the IgM-L group, which may also be associated more directly with higher urine protein levels (P=.02). A generalized linear mixed model showed a significantly higher urine albumin-to-creatinine ratio (P&lt;.01) and serum creatinine levels (P=.04), plus lower serum albumin level (P&lt;.01) in IgM-H consistently during 5-year follow-up.Limitations of the study include its retrospective, single-center design; lack of detailed therapy regimens and long-term follow-up data; and potential effects of confounding factors. Further studies across multiple centers are needed to confirm any conclusions.&ldquo;To summarize,&rdquo; the authors wrote, &ldquo;our research offered further findings on the clinical significance of glomerular IgM deposits in patients with IgAN. Notably, the prognosis of IgM+ was not markedly worse compared [with] IgM&minus;. In IgAN patients with positive IgM deposits, however, increased intensity of glomerular IgM deposits may contribute adversely to clinicopathologic presentation and the outcome, with persistently lower serum albumin, higher urine albumin-to-creatinine ratio and serum creatinine levels during the follow-up. Decreased intensity of IgM deposits was determined as an independent protective factor in those patients.&rdquo;Source: <a href="https://doi.org/10.1080/0886022X.2024.2386146" target="_blank" rel="noopener">Renal Failure</a>

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Glomerular IgM Deposit in IgAN

IgA Nephropathy

The impact of glomerular IgM deposit on the progression of IgA nephropathy (IgAN) is unclear.

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