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Published on: October 13, 2023
Crohn's disease-associated IgA nephropathy may prone to better renal outcome
Zhihui Yang1, Xiaochang Xu2, Yejing Dong2
1The Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Biomedical Innovation Center, Guangzhou, Guangdong, China.
Insights
Crohn's Disease-associated IgA nephropathy (CD-IgAN) shows milder kidney function decline than primary IgA nephropathy (PIgAN). Patients with CD-IgAN experience better remission rates for proteinuria and hematuria after treatment.
Area of Science:
- Nephrology
- Gastroenterology
- Internal Medicine
Background:
- Renal involvement in Crohn's Disease (CD) is uncommon, with limited understanding of its association with IgA nephropathy (IgAN).
- Distinguishing between CD-associated IgA nephropathy (CD-IgAN) and primary IgA nephropathy (PIgAN) is crucial for patient management.
Purpose of the Study:
- To investigate and compare the clinical and outcome features of CD-IgAN and PIgAN.
- To identify differences in renal function, pathology, and treatment response between the two conditions.
Main Methods:
- A retrospective study was conducted involving 17 patients with CD-IgAN and 87 patients with PIgAN.
- Clinical data were collected from kidney biopsies performed between January 2016 and June 2023.
Main Results:
- CD-IgAN patients exhibited significantly lower urinary protein excretion and better estimated glomerular filtration rates compared to PIgAN patients.
- Renal pathology in CD-IgAN showed a lower incidence of tubular atrophy and interstitial fibrosis.
- Complete remission of proteinuria and hematuria was more frequent in CD-IgAN patients after twelve months of treatment.
Conclusions:
- CD-IgAN is associated with a milder progression of renal dysfunction compared to PIgAN.
- Patients with CD-IgAN demonstrate a greater likelihood of remission for proteinuria and hematuria following treatment.
Background And Aim:
Renal involvement in Crohn's Disease (CD) was rare in the population. Little was known between IgA nephropathy and CD. This study aimed to investigate the differences in clinical and outcome features of CD-associated IgA nephropathy (CD-IgAN) and primary IgA nephropathy (PIgAN).
Methods:
Clinical data of patients diagnosed with IgAN by kidney biopsy were collected in the Sixth Affiliated Hospital of Sun Yat-sen University from January 1st, 2016 to June 1st, 2023. 17 patients with CD-IgAN and 87 patients with PIgAN were enrolled in this retrospective study.
Results:
Compared with PIgAN patients, CD-IgAN patients had lower levels of urinary protein excretion (1.57 g per 24 h vs. 0.33 g per 24 h, p < 0.01), but higher levels of estimated glomerular filtration rate (77.63 ± 40.11 ml per min per 1.73m2 vs. 104.53 ± 32.97 ml per min per 1.73m2, p = 0.008). From the point of renal pathology of PIgAN, patients with CD-IgAN had a less incidence of tubular atrophy or interstitial fibrosis (p = 0.001). CD-IgAN patients had a higher incidence of complete remission of proteinuria (45.8% vs. 81.8%, p = 0.031) or hematuria (10.4% vs. 45.4%, p = 0.019) than PIgAN patients after twelve-month treatments.
Conclusions:
CD-IgAN manifests a milder progression of renal function than those PIgAN. After the treatment, proteinuria or hematuria are more prone to remit in patients with CD-IgAN.
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