Clinical significance of the time-average systemic immunoinflammatory index in primary immunoglobulin A nephropathy: a bicentric retrospective cohort study.

IF 2.9 3区医学 Q1 UROLOGY & NEPHROLOGY

Kidney Research and Clinical Practice Pub Date : 2025-04-25 DOI:10.23876/j.krcp.24.260

Ya Hu, Ziyuan Huang, Wanwan Zhao, Hong Zhang, Ganxiu Li, Sishi Lin, Fangfang Feng, Chaosheng Chen, Zewen Liu

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引用次数: 0

Abstract

Background: Systemic immune inflammation index (SII) is a potential marker that can reflect the systemic inflammatory response. However, the clinical significance of SII for immunoglobulin A nephropathy (IgAN) has yet to be determined.

Methods: This was a retrospective analysis, covering January 2011 to December 2023, involving 1,399 IgAN patients confirmed through renal biopsy. The low TASII (L-TASII) group comprised patients with a time-average SII (TASII) below the top third of the cohort, whereas the high TASII (H-TASII) group included all remaining patients. All patients were matched 1:1 according to age, sex, follow-up time, and baseline estimated glomerular filtration rate (eGFR). Clinical pathology and prognosis were assessed and compared between the two groups.

Results: After matching, the L-TASII and H-TASII groups each feature 556 cases. Patients in the H-TASII group had lower albumin levels (36.88 ± 6.24 g/L vs. 37.93 ± 5.45 g/L, p = 0.01) and higher proteinuria levels (2.19 ± 2.25 g/day vs. 1.75 ± 2.07 g/day, p = 0.003). With an eGFR ≥30% when compared with the baseline or end-stage renal disease as the composite endpoint events, Kaplan-Meier curve analysis revealed that after an average follow-up of 59.91 ± 32.42 months, the survival rate was markedly lower in the H-TASII group than in L-TASII group (log-rank p < 0.01). Analysis revealed that TASII levels are independent predictors for the occurrence of endpoint events (hazard ratio, 1.02; 95% confidence interval, 1.01-1.04; p = 0.001).

Conclusion: IgAN patients with a high TASII have more serious clinical manifestations such as creatinine, urinary protein, and inflammatory markers, while there is a worse prognosis for patients with low TASII. Thus, the TASII score represents a significant risk factor for adverse renal outcomes in IgAN patients and serves as a reliable predictor of renal survival.

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原发性免疫球蛋白A肾病的时间平均全身免疫炎症指数的临床意义：一项双中心回顾性队列研究。

背景：全身免疫炎症指数（Systemic immune inflammation index， SII）是反映全身炎症反应的潜在指标。然而，SII对免疫球蛋白A肾病（IgAN）的临床意义尚未确定。方法：回顾性分析2011年1月至2023年12月，1399例经肾活检确诊的IgAN患者。低TASII （L-TASII）组包括时间平均SII （TASII）低于队列前三分之一的患者，而高TASII （H-TASII）组包括所有剩余患者。所有患者根据年龄、性别、随访时间和基线肾小球滤过率（eGFR）进行1:1匹配。比较两组患者的临床病理及预后。结果：匹配后，L-TASII组和H-TASII组各有556例。H-TASII组患者白蛋白水平较低（36.88±6.24 g/L vs. 37.93±5.45 g/L, p = 0.01），蛋白尿水平较高（2.19±2.25 g/d vs. 1.75±2.07 g/d, p = 0.003）。以eGFR≥30%与基线或终末期肾病相比较为复合终点事件，Kaplan-Meier曲线分析显示，平均随访59.91±32.42个月后，H-TASII组的生存率明显低于L-TASII组（log-rank p < 0.01）。分析显示TASII水平是终点事件发生的独立预测因子(风险比，1.02；95%置信区间为1.01-1.04；P = 0.001)。结论：高TASII IgAN患者肌酐、尿蛋白、炎症指标等临床表现更为严重，而低TASII IgAN患者预后较差。因此，TASII评分是IgAN患者肾脏不良结局的重要危险因素，是肾脏生存的可靠预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.