Lupus Nephritis With Obvious IgA Deposits in the Kidneys.

BACKGROUND: The purpose of the current study was to describe the clinico-pathological characteristics and outcomes in patients with lupus nephritis with IgA deposits in the kidneys. METHODS: A total of 258 patients with lupus nephritis with complete clinical data and follow-up was enrolled. They were divided into two groups: the IgA deposits group and the non-IgA deposits group. Their clinico-pathological features and outcomes between the two groups were further compared. RESULTS: Patients with IgA deposits had significantly lower prevalence of acute kidney failure, higher eGFR, lower plasma levels of C3a, and lower renal pathological chronicity indices scores than those with non-IgA deposits (19.4% vs. 31.8%, 86.2 [52.8, 110.7] vs. 77.6 [32.2, 101.7] ml/min/1.73m2, 1045.48 [559.41, 1796.34] vs. 1920.77 [1155.08, 2986.96]ng/ml, and 2 [1, 3] vs. 2.5 [2, 4], respectively, all P < 0.05). Patients with IgA deposits also had a higher frequency of the CFH rs6677604-AA/GA genotype in comparison with those with non-IgA deposits (12.0% vs. 8.2%, P = 0.469). Using the multivariable Cox hazard analysis, the IgA deposits were identified as a protective factor of survival from the composite events (HR 0.423; 95% CI, 0.219 to 0.816; P = 0.01). CONCLUSIONS: Patients with IgA deposits presented with milder renal damage and a good prognosis, which suggested its protective role in lupus nephritis.