在IgA病中复发和长期结局之间的关联
Xue Shen1,2,3,4, Pei Chen1,2,3,4, Miao Hui1,2,3,4,5
1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
Kidney medicine
|November 10, 2025
概括
在IgA脏病 (IgAN) 缓解后复发很常见,增加病进展. 在缓解后控制蛋白尿尿低于0.3g/d显著降低了复发风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
- 临床研究 临床研究
背景情况:
- 在IgA病 (IgAN) 复发后缓解的研究不足.
- 了解复发发病率和风险因素对于患者的治疗结果至关重要.
研究的目的:
- 在一个潜在的队列中调查IgAN复发发病率.
- 评估复发和脏不良结果之间的关联.
- 确定IGAN复发的临床病理预测因素.
主要方法:
- 对1069名处于缓解状态的IgAN患者进行前性队列研究.
- 考克斯回归和LASSO考克斯回归分析了复发预测因素.
- 结果包括末期病或50%的eGFR下降.
主要成果:
- 33%的患者经历了复发.
- 复发显著增加了结点事件,加速了eGFR的下降.
- 皮质类固醇诱导的缓解与更高的早期复发有关;缓解后蛋白尿 <0.3 g/d改善了无复发率.
结论:
- IgAN 复发很普遍,并且与更糟糕的结局有关.
- 临床病理学因素和药物预测复发.
- 在缓解期严格控制蛋白尿 (<0.3 g/d) 是减少复发的关键.
相关概念视频
Acute Kidney Injury III: Clinical Manifestations
791
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
791
Acute Kidney Injury I: Introduction
549
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
549
Acute Kidney Injury IV: Diagnostic Studies and Prevention
254
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
254
Chronic Kidney Disease III: Interprofessional Care
331
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
331
Acute Kidney Injury II: Pathophysiology
865
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
865
Chronic Kidney Disease II: Clinical Manifestations
537
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
537


