The importance of the degree of foot process effacement in evaluating the prognosis of IgA nephropathy.

Abstract

Objective: The aim of this study is to analyze the 5 year prognosis of IgA nephropathy (IgAN) patients with varying degrees of foot process effacement (FPE).

Method: We retrospectively analyzed the clinical and pathological data of 863 patients with primary IgAN confirmed by renal biopsy at Hangzhou Traditional Chinese Medicine Hospital from 1 January 2015 to 31 December 2018. According to the degree of FPE, the group was divided into extensive FPE group and segmental FPE group. After propensity score matching (PSM), the effect of different levels of FPE on the prognosis of IgAN was analyzed using Log-rank tests.

Result: Notably, 61(7.1%) of the 863 patients reached renal composite endpoint. 53 patients in the foot process extensive effacement group were matched with 100 patients in the segmental effacement group after propensity score matching. There were no significant differences in any of the baseline characteristics between the two groups (P > 0.05). Additionally, Kaplan-Meier survival analysis revealed that patients with extensive FPE (≥ 50%) exhibited a significantly poorer prognosis compared with those with segmental FPE (< 50%) (Log-rank test P = 0.030).In the Pearson correlation analysis, FPE was moderately positively associated with albuminuria and mildly negatively associated with eGFR.

Conclusion: Extensive foot process effacement is an independent risk factor for IgAN prognosis.