What question did this study set out to answer?

This research aims to evaluate the impact of combined IgM and C3 staining on renal outcomes in IgA nephropathy patients.

January 25, 2026Open Access

Clinical Significance of Combined IgM and C3 Staining in Primary IgA Nephropathy

Key Points

This research aims to evaluate the impact of combined IgM and C3 staining on renal outcomes in IgA nephropathy patients.
Retrospective review of 69 adult patients with IgA nephropathy.
Assessment of demographic and clinical data including blood pressure, protein levels, and kidney function.
Categorization of kidney biopsy using Oxford classification and MEST-C score.
Division of subjects into IgM-positive and IgM-negative groups and further into four staining groups.
The IgM-positive group showed significantly higher levels of systolic blood pressure, serum creatinine, and urinary protein.
62.3% of patients had both IgM and C3 on their glomeruli, correlating to worse outcomes.
The IgM + C3 + group had a higher prevalence of renal dysfunction compared to other groups.

Abstract

Background We aimed to investigate the clinical significance of combined glomerular IgM and C3 staining and renal outcome in adult IgA nephropathy (IgAN). Materials and Methods This retrospective study encompassed 69 adult patients with IgAN. The demographic and clinical data, including sex, age, diastolic blood pressure (DBP), systolic blood pressure (SBP), 24-hour urinary total protein (24hUP), WBCs, serum hemoglobin (Hb), serum platelets (PLT), serum creatinine (Scr), blood uric nitrogen (BUN), estimated glomerular filtration rate (eGFR), serum albumin (ALB), uric acid (UA), total cholesterol (CHO), triglyceride (TG), IgA, IgG, IgM, and complement 3 and 4 (C3 and C4) were evaluated at baseline. Kidney biopsy was categorized using the Oxford classification, along with the Mesangial hypercellularity, endocapillary hypercellularity, segmental glomerulosclerosis, tubular atrophy/interstitial fibrosis, glomerular crescent, (MEST-C) score. The patients were divided into IgM-positive (IgM + ) and-negative (IgM - ) groups for analysis. Further, they were divided into four groups by glomerular IgM and C3 staining: IgM-positive C3-positive (IgM + C3 + ) staining group, IgM-positive C3-negative (IgM + C3 - ) staining group, IgM-negative C3-positive (IgM - C3 + ) staining group, and IgM-negative C3-negative (IgM - C3 - ) staining group. The hard renal endpoint was the onset of end-stage kidney disease (ESKD) within the follow-up period. Results The IgM + group (n=47, 68%) had significantly higher levels of SBP, Scr, BUN, IgM, TG, 24hUP, tubular atrophy, and vessel hyaline change. Further analysis indicated that 43 (62.3%) patients had combined mesangial IgM and C3 deposition (IgM + C3 + staining group). Compared with the other three groups, patients with combined IgM and C3 deposition had higher levels of DBP, SBP, Scr, BUN, IgM, TG, and 24-hour urine protein (24hUP), as well as tubular atrophy. We observed that the IgM + C3 + group had a higher prevalence of renal dysfunction compared to the other groups. Conclusion IgM positivity in patients with IgA showed a worse renal outcome. IgM + C3 + staining in patients with IgAN experienced a higher renal dysfunction prevalence.

Read Full Paperexternally

Bookmark

View Full Paper

Cite This Study

Li et al. (Fri,) studied this question.

synapsesocial.com/papers/6975b1a9feba4585c2d6d287 https://doi.org/https://doi.org/10.25259/ijn_711_2024

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Bookmark

View Full Paper