GLOMERULAR GALACTOSE-DEFICIENT IGA1(KM55) POSITIVE MAY BE ASSOCIATED WITH POOR PROGNOSIS IN DKD PATIENTS

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https://storage.unitedwebnetwork.com/files/1099/b2cbd0a450f7cf1bbfeabbd9829407f3.pdf

Abstract Title

First Name *

Hong

Last Name *

Cheng

Co-author 1

Xiaoyi Xu doctorxuxiaoyi@126.com Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 2

Weiyi Guo guoweiyi1988@163.com Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 3

Lijun Sun blsunlj@163.com Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 4

Guoqin Wang wangguoqin1@163.com Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 5

Wenrong Cheng chengwenrong@bjmu.edu.cn Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 6

Hongrui Dong donghongrui@163.com Beijing Anzhen Hospital, Capital Medical University Renal Division Beijing

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Diabetic kidney disease (DKD) and IgA nephropathy (IgAN) are prevalent renal diseases with a high incidence rate, and the prognosis is notably poorer when these two diseases coexist. However, it remains uncertain whether the pathological changes associated with DKD combined with IgA deposition (DKD-IgA deposition) are linked to a worsened prognosis.

Methods

To address this question, we conducted an analysis comparing the clinicopathological characteristics and prognosis of DKD-IgA deposition patients to DKD patients as controls.

Results

The results revealed that DKD-IgA patients exhibited higher cholesterol levels compared to DKD patients (6.2±2.0 vs.5.4±1.9 mmol/L, p=0.042). The group with DKD-IgA deposition had a significantly shorter follow-up duration (10.9±10.6 months) compared to the control group (20.4±18.7 months, p=0.029). However, they exhibited higher levels of serum creatinine at the end of the follow-up period (343.8±328.0μmol/L vs. 182.1±124.6μmol/L, p=0.031). Kaplan-Meier analysis showed a higher cumulative incidence of poor events in the DKD-IgA deposition group (p=0.036). In addition, we also detected galactose deficient IgA1 (KM55) in the kidneys and serum of patients with DKD-IgA deposition. Of the 24 patients with DKD-IgA deposition, 54.5% (24/44) showed positive glomerular KM55 results. Immunofluorescence analysis revealed that KM55 and IgA were predominantly colocalized in the mesangial and capillary regions. Furthermore, the subgroup with KM55 positivity had a shorter disease duration compared to the KM55 negative subgroup (66.0 vs. 120.0 months, p=0.048). The serum levels of galactose-deficient IgA1 (Gd-IgA1) (6296.4±1535.4 vs. 4057.4±1082.0 ng/mL, p =0.010) and C4 (0.4±0.1 vs. 0.3±0.1 g/L, p =0.020) were significantly higher in the KM55 positive subgroup than in the KM55 negative subgroup. Furthermore, it was observed that the KM55 positive subgroup exhibited a considerably higher incidence of reaching the renal endpoint compared to the control group (64.3% vs. 20.0%, p = 0.047).

Conclusions

These study results suggest that individuals with DKD who display glomerular IgA deposition alongside KM55 positivity may experience a more unfavorable prognosis.

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