Authors
Anni Wang, Wen Shi, Kunyue Xu, Yuan Yuan, Xuanli Tang, Shuman Zhao, Dongrong Yu, Hong Liu, Xiang Liu, Xue Jiang
Published in
Annals of medicine. Volume 58. Issue 1. Pages 2726611. Epub Sep 09, 2026.
Abstract
This study characterized clinical features, pathology, treatment, and prognosis of biopsy-confirmed coexisting IgA nephropathy (IgAN) and diabetic kidney disease (DKD).
This single-centre retrospective study included 80 patients with biopsy-proven IgAN + DKD (2010-2023). Propensity score matching (PSM) (1:1) was used to establish comparable groups of IgAN (n = 80) and DKD (n = 80), matched on age, sex and baseline serum creatinine (sCr). Baseline clinical and pathological data, treatments, 1-year response and long-term outcomes were compared.
In the unmatched cohort, IgAN + DKD patients had higher baseline sCr, greater 24-hour urinary protein (24h-uPro), and less microscopic haematuria (MH) than IgAN. After matching, differences in 24h-uPro and MH persisted. IgAN + DKD showed fewer crescents, lower KM55/IgA ratio, and weaker C3 deposition. Versus DKD, IgAN + DKD had more MH but milder glomerular lesions and arteriolar hyalinosis. In patients with 1-year data (n = 31), 24h-uPro of IgAN+DKD declined substantially, with 58.06% overall clinical remission. Median time free of the composite kidney endpoint (≥50% estimated glomerular filtration rate (eGFR) decline or kidney failure) was 65.63 months; risk was higher than IgAN (HR 2.821, 95% CI 1.174-6.781) but lower than DKD (HR 0.525, 95% CI 0.293-0.943). Baseline sCr and irreversible GBM thickening associated with endpoints. Unselected immunosuppression showed no long-term renal benefit.
IgAN + DKD exhibited lower intrarenal immune activity than IgAN and less severe diabetic glomerular injury than DKD. The KM55/IgA ratio might aid differentiation from IgAN. Long-term renal prognosis was intermediate between the monodisease groups. Routine immunosuppression reduced short-term proteinuria but did not improve hard renal endpoints. Higher baseline sCr and GBM thickness linked to poorer outcomes.
PMID:
42714219
Bibliographic data and abstract were imported from PubMed on 09 Sep 2026.
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