The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy

Introduction: IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) worldwide. The disease course fluctuates, and the most important challenge is the considerable variation in the time lag between diagnosis and the development of a hard clinical end point, such as end-stage kidne...

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Autores: Rodas L, Barnadas E, Pereira A, Castrejon N, Saurina A, Calls J, Calzada Y, Madrid Á, Blasco M, Poch E, García-Herrera A, Quintana LF
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p21448
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21448
Access Level:acceso abierto
Palabra clave:end-stage kidney disease
IgAN
lymphatics
proteinuria
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spelling The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA NephropathyRodas LBarnadas EPereira ACastrejon NSaurina ACalls JCalzada YMadrid ÁBlasco MPoch EGarcía-Herrera AQuintana LFend-stage kidney diseaseIgANlymphaticsproteinuriaIntroduction: IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) worldwide. The disease course fluctuates, and the most important challenge is the considerable variation in the time lag between diagnosis and the development of a hard clinical end point, such as end-stage kidney disease (ESKD). The reaction of renal tissue to damage resembles the common wound-healing response. One part of this repair in IgAN is the expansion of lymphatic vessels known as lymphangiogenesis. The aim of this work was to establish the prognostic value of the density of lymphatic vessels in the renal biopsy at the time of diagnosis, for predicting the risk of ESKD in a Spanish cohort of patients with IgAN. Methods: We performed a retrospective multicenter study of 76 patients with IgAN. The end point of the study was progression to ESKD. The morphometric analysis of lymphatic vessels was performed on tissue sections stained with antipodoplanin antibody. Results: Density of lymphatic vessels was significantly higher in patients with IgAN with mesangial hypercellularity >50%, segmental sclerosis, higher degrees of interstitial fibrosis, and tubular atrophy. Patients with more lymphatic vessels had significantly higher values of proteinuria and lower estimated glomerular filtration rate (eGFR). A density of lymphatic vessels >= 8 per mm(2) was associated with a significantly higher rate of progression to ESKD at 3 years from biopsy. After adjustment for the International IgAN prediction score, at the multivariate logistic regression, high density of lymphatic vessels (>= 8 per mm(2)) remained significantly associated with a higher rate of early progression to ESKD. Conclusion: This study contributes to the understanding of the natural history of the progression to ESKD in patients with IgAN revealing the density of lymphatics vessels may optimize the prognostic value of the International IgA predicting tool to calculate the risk of ESKD, favoring the evaluation of new targeted therapies.ELSEVIER SCIENCE INC2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21448Kidney International ReportsISSN: 24680249reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p214482026-05-27T12:37:41Z
dc.title.none.fl_str_mv The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
title The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
spellingShingle The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
Rodas L
end-stage kidney disease
IgAN
lymphatics
proteinuria
title_short The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
title_full The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
title_fullStr The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
title_full_unstemmed The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
title_sort The Density of Renal Lymphatics Correlates With Clinical Outcomes in IgA Nephropathy
dc.creator.none.fl_str_mv Rodas L
Barnadas E
Pereira A
Castrejon N
Saurina A
Calls J
Calzada Y
Madrid Á
Blasco M
Poch E
García-Herrera A
Quintana LF
author Rodas L
author_facet Rodas L
Barnadas E
Pereira A
Castrejon N
Saurina A
Calls J
Calzada Y
Madrid Á
Blasco M
Poch E
García-Herrera A
Quintana LF
author_role author
author2 Barnadas E
Pereira A
Castrejon N
Saurina A
Calls J
Calzada Y
Madrid Á
Blasco M
Poch E
García-Herrera A
Quintana LF
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv end-stage kidney disease
IgAN
lymphatics
proteinuria
topic end-stage kidney disease
IgAN
lymphatics
proteinuria
description Introduction: IgA nephropathy (IgAN) is the most common primary glomerulonephritis (GN) worldwide. The disease course fluctuates, and the most important challenge is the considerable variation in the time lag between diagnosis and the development of a hard clinical end point, such as end-stage kidney disease (ESKD). The reaction of renal tissue to damage resembles the common wound-healing response. One part of this repair in IgAN is the expansion of lymphatic vessels known as lymphangiogenesis. The aim of this work was to establish the prognostic value of the density of lymphatic vessels in the renal biopsy at the time of diagnosis, for predicting the risk of ESKD in a Spanish cohort of patients with IgAN. Methods: We performed a retrospective multicenter study of 76 patients with IgAN. The end point of the study was progression to ESKD. The morphometric analysis of lymphatic vessels was performed on tissue sections stained with antipodoplanin antibody. Results: Density of lymphatic vessels was significantly higher in patients with IgAN with mesangial hypercellularity >50%, segmental sclerosis, higher degrees of interstitial fibrosis, and tubular atrophy. Patients with more lymphatic vessels had significantly higher values of proteinuria and lower estimated glomerular filtration rate (eGFR). A density of lymphatic vessels >= 8 per mm(2) was associated with a significantly higher rate of progression to ESKD at 3 years from biopsy. After adjustment for the International IgAN prediction score, at the multivariate logistic regression, high density of lymphatic vessels (>= 8 per mm(2)) remained significantly associated with a higher rate of early progression to ESKD. Conclusion: This study contributes to the understanding of the natural history of the progression to ESKD in patients with IgAN revealing the density of lymphatics vessels may optimize the prognostic value of the International IgA predicting tool to calculate the risk of ESKD, favoring the evaluation of new targeted therapies.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21448
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21448
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER SCIENCE INC
publisher.none.fl_str_mv ELSEVIER SCIENCE INC
dc.source.none.fl_str_mv Kidney International Reports
ISSN: 24680249
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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