ArticlePloS one2020
Evidences of histologic thrombotic microangiopathy and the impact in renal outcomes of patients with IgA nephropathy.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Prognostic value of vascular lesions in immunoglobulin a nephropathy: a meta-analysis.BMC nephrology · 2026Pooled it
- Low-density granulocyte-driven NET formation is associated with poor prognosis in IgA nephropathy with thrombotic microangiopathy.Renal failure · 2026Article
- A mixed presentation of IgA nephropathy and malignant hypertension with histological thrombotic Microangiopathy.Oxford medical case reports · 2026Article
- Immunoglobulin A Nephropathy With Associated Thrombotic Microangiopathy: Biopsy and Clinical Case Series.Clinical medicine insights. Case reports · 2026Article
- Complement biomarkers in IgA nephropathy: current insights and clinical relevance.Frontiers in nephrology · 2026Review
- Impact of intrarenal arterial lesions on prognosis of IgA nephropathy: insights from a retrospective cohort study.Renal failure · 2025Article
- An Expert Opinion on Current and Future Treatment Approaches in IgA Nephropathy.Advances in therapy · 2025Article
- Novel Biomarkers as Non-Invasive Diagnostic Tools in IgA Nephropathy: A Comparative Study with Lupus Nephritis and Membranous Nephropathy.Journal of inflammation research · 2025Article
- C3 Hypocomplementemia Predicts the Progression of CKD towards End-Stage Kidney Disease in IgA Nephropathy, Irrespective of Histological Evidence of Thrombotic Microangiopathy.Journal of clinical medicine · 2024Article
- Microangiopathy associated with poor outcome of immunoglobulin A nephropathy: a cohort study and meta-analysis.Clinical kidney journal · 2024Article
- Vascular injury in glomerulopathies: the role of the endothelium.Frontiers in nephrology · 2024Review
- Targeting complement in IgA nephropathy.Clinical kidney journal · 2023Review
- A new pathological perspective on thrombotic microangiopathy.Kidney research and clinical practice · 2022Article
- IgA nephropathy and atypical hemolytic uremic syndrome: a case series and a literature review.Journal of nephrology · 2022Review
- Complement in Secondary Thrombotic Microangiopathy.Kidney international reports · 2021Review
- Emerging perspectives in the management of IgA nephropathy: a comprehensive review.Porto biomedical journalReview
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Authors and funding
14 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIgA nephropathy (IgAN) is the most common primary glomerulopathy worldwide. According to the Oxford Classification, changes in the kidney vascular compartment are not related with worse outcomes. This paper aims to assess the impact of thrombotic microangiopathy (TMA) in the outcomes of Brazilian patients with IgAN. MATERIALS AND
methodsAnalysis of clinical data and kidney biopsy findings from patients with IgAN to assess the impact of TMA on renal outcomes.
resultsThe majority of the 118 patients included were females (54.3%); mean age of 33 years (25;43); hypertension and hematuria were observed in 67.8% and 89.8%, respectively. Median creatinine: 1.45mg/dL; eGFR: 48.8ml/min/1.73m2; 24-hour proteinuria: 2.01g; low serum C3: 12.5%. Regarding to Oxford Classification: M1: 76.3%; E1: 35.6%; S1: 70.3%; T1/T2: 38.3%; C1/C2: 28.8%. Average follow-up: 65 months. Histologic evidence of TMA were detected in 21 (17.8%) patients and those ones presented more frequently hypertension (100% vs. 61%, p <0.0001), hematuria (100% vs 87.6%, p = 0.0001), worse creatinine levels (3.8 vs. 1.38 mg/dL, p = 0.0001), eGFR (18 vs. 60 ml/min/1.73m2), p = 0.0001), low serum C3 (28.5% vs. 10.4%, p = 0.003), lower hemoglobin levels (10.6 vs. 12.7g/dL, p<0.001) and platelet counts (207,000 vs. 267,000, p = 0.001). Biopsy findings of individuals with TMA revealed only greater proportions of E1 (68% vs. 32%, p = 0.002). Individuals with TMA were followed for less time (7 vs. 65 months, p<0.0001) since they progressed more frequently to chronic kidney disease (CKD) requiring kidney replacement therapy (KRT) (71.4% vs. 21,6%, p<0.0001). Male sex, T1/T2, and TMA were independently associated with progression to CKD-KRT.
conclusionsIn this study patients with TMA had worse clinical manifestations and outcomes. In terms of histologic evidence, E1 distinguished patients with TMA from other patients. Further studies are necessary to analyze the impact of vascular lesions on IgAN prognosis.
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