ArticleBMC nephrology2026
A comparative study on the clinicopathological features and short-term prognosis of IgA-dominant infection-related glomerulonephritis and IgA nephropathy.
Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
backgroundIgA-dominant infection-related glomerulonephritis (IgA-IRGN) and primary IgA nephropathy (IgAN) share similar clinicopathological features, making differentiation challenging despite distinct therapeutic strategies. This study compares the clinicopathological characteristics and short-term prognoses of the two conditions to identify diagnostic differentiators.
methodsThis retrospective study included patients diagnosed with IgA-IRGN (n = 30) and IgAN (n = 120). We comparatively analyzed their clinical and pathological features, as well as the short-term prognostic differences. Univariate and multivariable logistic regression analyses were conducted to evaluate independent associations. Different pathological scoring systems were utilized to assess their diagnostic value. Short-term prognosis was evaluated at a 6-month follow-up, based on changes in the estimated glomerular filtration rate (eGFR) and the remission rate of proteinuria.
resultsCompared to IgAN, IgA-IRGN patients had higher mean arterial pressure, incidences of edema, acute kidney injury (AKI), and hypertension. Serum albumin, eGFR, and complement C3 were lower, while 24-hour proteinuria, neutrophil-to-albumin ratio (NAR), and neutrophil-to-C3 ratio (NC3r) were higher. Pathologically, IgA-IRGN showed diffuse endocapillary hypercellularity (100% vs. 2.5%) and universal subepithelial "hump-like" deposits (100% vs. 0.89%). Multivariable analysis revealed hypocomplementemia C3, AKI, and serum albumin could serve as non-invasive differentiating indicators. After incorporating pathological factors, hypocomplementemia C3, the Lupus Nephritis Activity Index (AI) score, and diffuse foot process effacement emerged as independent differentiating factors. IgA-IRGN patients demonstrated better short-term renal function recovery and higher proteinuria remission rate (P < 0.05).
conclusionsSignificant clinicopathological differences exist between IgA-IRGN and IgAN. Hypocomplementemia C3, AKI, low serum albumin, diffuse foot process effacement, and the AI score were independent indicators for differentiation. IgA-IRGN patients experience better short-term renal recovery and proteinuria remission than IgAN patients.
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