DECODING HEPATORENAL CROSS-TALK IN IgA NEPHROPATHY WITH CHRONIC LIVER DISEASE: QUANTITATIVE INSIGHTS FROM A CORRELATIVE STUDY

 

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https://storage.unitedwebnetwork.com/files/1099/8165afb26e73183be3b880c3525313c3.pdf
DECODING HEPATORENAL CROSS-TALK IN IgA NEPHROPATHY WITH CHRONIC LIVER DISEASE: QUANTITATIVE INSIGHTS FROM A CORRELATIVE STUDY

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Venkat Praneeth Reddy
Kalva
Venkat Praneeth Reddy Kalva kvpr2000@icloud.com AIG Hospitals Department of Nephrology Hyderabad India *
Prathyusha Bollam Prathyushabollam9@gmail.com AIG Hospitals Department of Nephrology Hyderabad India -
Pallavi Kumari Pallavikumari454@gmail.com AIG Hospitals Department of Nephrology Hyderabad India -
Niranjana Rekha Paladugu dr.niranjanar@aighospitals.com AIG Hospitals Department of Nephrology Hyderabad India -
Anand V Kulkarni anandvk90@gmail.com AIG Hospitals Department of Gastroenterology Hyderabad India -
Sujith Reddy R jeet.0311@gmail.com AIG Hospitals Department of Nephrology Hyderabad India -
Sai Ram Reddy Keithi skeithireddy@gmail.com AIG Hospitals Department of Nephrology Hyderabad India -
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Hepatorenal cross-talk is well established in hepatorenal syndrome (HRS); however, the structural–functional interrelationship between the kidney and liver in patients with IgA nephropathy (IgAN) coexisting with chronic liver disease (CLD) has not been quantitatively delineated. This study aimed to characterize the bidirectional kidney–liver interactions in this population and determine whether their correlation pattern mirrors HRS-like physiology.

A retrospective study was conducted in 60 patients with biopsy-proven IgAN and concomitant CLD. Renal parameters—serum creatinine, estimated glomerular filtration rate (eGFR), and urine protein–creatinine ratio (UPCR)—were evaluated alongside liver disease markers including albumin, total bilirubin, sodium, international normalized ratio (INR), Model for End-Stage Liver Disease–Sodium (MELD-Na) score, and Child–Pugh grade. Correlations were assessed by Pearson or Spearman methods, and linear regression models quantified predictive relationships between liver and kidney indices.

Kidney Liver CorrelationSr Creatinine vs MELD NaeGFR vs MELD Na                                                                                                                        Kidney function - Child Pugh Comparison                                                                                                                            Strong correlations were identified between kidney dysfunction and liver disease severity. Serum creatinine demonstrated a strong positive correlation with MELD-Na score (r=0.738, p<0.001), with the regression equation: Creatinine = -0.105 + 0.150 × MELD_Na (R²=0.545). eGFR showed a strong negative correlation with MELD-Na (r=-0.668, p<0.001), with regression: eGFR = 85.5 - 2.63 × MELD_Na (R²=0.446). UPCR negatively correlated with serum sodium (r=-0.286, p=0.033). Subgroup analysis revealed significantly higher MELD-Na scores (p=0.007), INR (p=0.012), and lower serum sodium (p=0.009) and albumin (p<0.001) in Child-Pugh Grade B versus Grade A patients.

Significant bidirectional kidney-liver interactions exist in patients with concurrent IgA nephropathy and chronic liver disease. The MELD-Na score emerges as the strongest predictor of kidney dysfunction severity, explaining 54.5% of creatinine variance and 44.6% of eGFR variance. These findings support comprehensive assessment of both organ systems in patients with hepatic IgAN and highlight the importance of MELD-Na scoring for risk stratification.

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