Prognostic value of low-density lipoprotein cholesterol in IgA nephropathy and establishment of nomogram model

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Biostatistics

Background:

• Dyslipidemia, particularly elevated low-density lipoprotein cholesterol (LDL-C), is increasingly recognized as a significant factor in the progression of kidney diseases.
• IgA nephropathy (IgAN) is a common form of glomerulonephritis, and understanding its prognostic indicators is crucial for patient management.

Purpose of the Study:

• To investigate the association between baseline LDL-C levels and the renal prognosis of patients with IgA nephropathy.
• To develop and validate a nomogram-based prognostic model for predicting end-stage renal disease (ESRD) risk in IgAN patients.

Main Methods:

• A cohort of 519 IgAN patients was analyzed, with baseline LDL-C levels used to categorize patients into high (>2.60 mmol/L) and low (≤2.60 mmol/L) groups.
• Kaplan-Meier survival analysis assessed renal survival, while COX regression identified independent risk factors for ESRD.
• A nomogram model was constructed using significant predictors and evaluated for its predictive accuracy and calibration.

Main Results:

• Patients with higher baseline LDL-C exhibited significantly worse renal survival compared to those with lower LDL-C (p=0.003).
• Elevated LDL-C was confirmed as an independent risk factor for ESRD in IgAN patients (HR=3.135, p=0.016).
• The developed nomogram, incorporating LDL-C, segmental sclerosis, tubular atrophy/interstitial fibrosis, cardiovascular disease prevalence, and 24-hour proteinuria, demonstrated good predictive performance (AUCs ranging from 0.792 to 0.864) for 5-, 8-, and 10-year ESRD risk.

Conclusions:

• Elevated LDL-C levels serve as a significant predictive factor for poorer prognosis in IgA nephropathy.
• The established nomogram model provides a valuable tool for predicting individual ESRD risk in IgAN patients, aiding in clinical decision-making.