ABSTRACT
Background
Glomerular immunoglobulin M (IgM) deposition is common in diabetic kidney disease.
The clinical implication of IgM deposition in the renal tissues of type 2 diabetes
mellitus patients with biopsy-proven diabetic nephropathy remains unclear.
Materials and Methods
One hundred thirty-two patients with type 2 diabetes and biopsy-proven pure diabetic
nephropathy were enrolled retrospectively. Clinicopathological features and renal
outcomes were compared between patients with and without glomerular capillary IgM
deposition. A Cox proportional hazards model was employed to identify the risk factors
associated with renal survival.
Results
Fifty-two patients had positive linear glomerular capillary IgM staining. Patients
with glomerular capillary IgM deposition presented with heavier proteinuria, and lower
serum albumin. During 35.5 (12, 107) months of follow-up, patients with glomerular
tuft IgM deposition had shorter renal survival than those with negative IgM deposition
(39 [23.74, 54.26] versus (vs.) 64 [45.82, 82.18] months, P = 0.01). Patients with glomerular complement 1q (C1q) deposition showed worse renal
survival than those lacking glomerular C1q deposition (36 [23.82, 48.18] vs. 60 [50.27,
69.74] months, P = 0.001). Worse renal outcome was observed in patients with glomerular C3 deposition
than in those without glomerular C3 deposition (37 [22.43, 51.56] vs. 63 [51.75, 74.25]
months, P = 0.001). Multivariate Cox proportional analysis demonstrated that combined glomerular
capillary IgM and C1q deposition was an independent predictor of end-stage renal disease
(hazard ratio 3.75, 95% CI[ 1.68,8.35], P = 0.001).
Conclusions
Patients with diabetic nephropathy and combined glomerular capillary IgM and C1q deposition
had unfavorable renal outcome, which indicates that IgM derived from B cells might
be involved in diabetic kidney injury.
Key Indexing Terms
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Article info
Publication history
Published online: July 07, 2018
Accepted:
July 2,
2018
Received:
January 28,
2018
Footnotes
Conflict of interest: The authors declare that they have no conflict of interest.
Funding: This study was funded by the National Natural Science Foundation of China (Grant Number 81670662), Sichuan Science and Technology Program (Grant number 2016FZ0117).
Identification
Copyright
© 2018 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
