Moderate to severe chronic arteriolar lesions is an independent risk factor for adverse renal outcomes in IgA nephropathy
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Updated: May 10, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Qian Wu1, Yi Chen1, Miaoying Shen1
1Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Insights
Moderate to severe chronic arteriolar lesions in IgA nephropathy patients significantly increase the risk of adverse renal outcomes. This study identified these lesions and other factors as key predictors of kidney disease progression.
Area of Science:
- Nephrology
- Pathology
- Clinical Medicine
Background:
- The prognostic significance of chronic arteriolar lesions in IgA nephropathy is debated.
- Understanding these lesions is crucial for predicting IgA nephropathy progression.
Purpose of the Study:
- To evaluate the predictive value of varying degrees of chronic arteriolar lesions for IgA nephropathy prognosis.
- To identify risk factors associated with the development of these lesions.
Main Methods:
- Retrospective analysis of 574 IgA nephropathy patients diagnosed via renal biopsy.
- Classification of patients into four groups based on chronic arteriolar lesion severity.
- Kaplan-Meier, Cox regression, and ROC curve analyses were employed.
Main Results:
- Moderate to severe arteriolar lesions were associated with poorer clinical and pathological features.
- Moderate to severe chronic arteriolar lesions, creatinine, S1, E1, T2, and C2 independently predicted adverse renal outcomes.
- Creatinine, T2, and C2 were identified as independent risk factors for adverse outcomes in patients with moderate to severe lesions.
Conclusions:
- Moderate to severe chronic arteriolar lesions are an independent risk factor for adverse renal outcomes in IgA nephropathy.
- These findings highlight the importance of assessing arteriolar lesions for patient prognosis.
Background:
The impact of chronic arteriolar lesions on the prognosis of IgA nephropathy remains controversial. This study aims to explore the value of chronic arteriolar lesions of varying degrees in predicting the prognosis of IgA nephropathy patients and analyze the associated risk factors that contribute to the formation.
Methods:
A retrospective analysis was conducted on 853 patients diagnosed with IgA nephropathy through renal biopsy at Guangdong Provincial Hospital of Traditional Chinese Medicine between September 1, 2005, and December 31, 2021. Eventually, a total of 574 cases were included in this study. According to the degree of chronic arteriolar lesions, the patients were divided into four groups: no lesion group (n=115), mild lesion group (n=287), moderate lesion group (n=131), and severe lesion group (n=41). Relevant clinical and pathological features and renal outcomes were recorded. Kaplan-Meier analysis, Cox proportional hazards regression, and receiver operating characteristic (ROC) curve analysis were utilized to examine the relationship between different degrees of chronic arteriolar lesions and the prognosis of IgA nephropathy. Additionally, risk factors associated with the development of moderate to severe chronic arteriolar lesions were identified.
Results:
Worse clinical and pathological features were observed in the moderate to severe lesions group (P<0.05). Moderate to severe chronic arteriolar lesions (aHR=3.357, 95%CI: 1.018-11.071, P=0.047), creatinine, S1, E1, T2, and C2 were identified as independent risk factors for adverse renal outcomes. Cox multivariate regression analysis on moderate to severe chronic arteriolar lesions demonstrated that creatinine, T2, and C2 were independent risk factors for adverse renal outcomes in patients with moderate to severe chronic arteriolar lesions.
Conclusion:
Moderate to severe chronic arteriolar lesions independently increases the risk of adverse renal outcomes.
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