Retrospective analysis of crescent score in clinical prognosis of IgA nephropathy
Chen Ying,
Yang Yiya,
Liang Yumei,
Liu Manting,
Xiao Wei,
Hu Xiaofang
Affiliations
Chen Ying
Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha Clinical Research Center for Kidney Disease, Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, Hunan 410005, China
Yang Yiya
Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha Clinical Research Center for Kidney Disease, Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, Hunan 410005, China
Liang Yumei
Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha Clinical Research Center for Kidney Disease, Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, Hunan 410005, China
Liu Manting
Department of Nephrology and Laboratory of Kidney Disease, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha Clinical Research Center for Kidney Disease, Hunan Clinical Research Center for Chronic Kidney Disease, Changsha, Hunan 410005, China
Xiao Wei
Department of Urology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Human 410005, China
Hu Xiaofang
Department of Internal Medicine, Hunan Normal University School of Medicine, Changsha, Hunan 410013, China
The scoring of crescents (Cs) was recently added to the Oxford classification for IgA nephropathy (IgAN). Because of the short-term use of the C score in clinical practice, its validity and applicability need to be verified. We, retrospectively, analyzed the clinicopathological data of 144 primary IgAN patients diagnosed at our hospital from March 2017 to March 2019 and with complete ≥6-month follow-up data. We found that the C score was positively correlated with the Lee’s classification in the assessment of renal pathological changes and significantly correlated with increased proteinuria and decreased estimated glomerular filtration rate. Univariate Cox regression analysis showed an association of C formation with IgAN prognosis, and multivariate Cox regression indicated Cs as an independent prognosis factor. The optimal proportion of Cs for prognosis prediction by the receiver operating characteristic curve was 11%. Kaplan–Meier survival curve revealed a significantly decreased renal survival rate in patients with C proportions ≥11%. Further multivariate Cox regression analysis confirmed that the C proportion ≥11% is an independent risk factor for poor prognosis of IgAN patients. Our findings demonstrate that Cs are independently related to the prognosis of patients with IgAN, and the proportion of Cs ≥11% is an independent risk factor for poor outcomes.
