ArticleAnnals of medicine2026
Clinical characteristics and prognosis of IgA nephropathy and comorbid diabetic kidney disease.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsThis study characterized clinical features, pathology, treatment, and prognosis of biopsy-confirmed coexisting IgA nephropathy (IgAN) and diabetic kidney disease (DKD).
methodsThis 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 (
resultsIn 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.
conclusionsIgAN + 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.
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