Clinical and pathological characteristics of primary IgA nephropathy patients with different blood types / 中国医师杂志

ABSTRACT

Objective:To investigate the differences of clinical data and pathological changes in patients with primary IgA nephropathy (IgAN) with different blood types.Methods:The clinical and pathological data of patients with primary IgAN diagnosed by renal biopsy in the People's Hospital of Ningxia Hui Autonomous Region from May 2016 to May 2021 were collected. They were divided into groups A, O, B and AB according to blood group. The clinical manifestations and pathological changes of the four groups during renal biopsy were analyzed.Results:A total of 258 patients with primary IgAN were included, including 87 cases of type A, 74 cases of type O, 72 cases of type B and 25 cases of type AB. The male to female ratio was 1.34∶1, and the median age was 36 (29, 47) years old. There was no significant difference in age, sex, blood pressure, hemoglobin and renal function among the four groups (all P>0.05). Neutrophil gelatinase-associated lipocalin (NGAL) in patients with type A and B was higher than other groups (all P<0.05). There were no significant differences in mesangial cell hyperplasia (M), capillary cell hyperplasia (E), glomerular segmental sclerosis (S), renal tubule atrophy/interstitial fibrosis (T), crescent body (C) lesions and proportion of sclerosed glomeruli among the four groups (all P>0.05). Subgroup analysis by gender showed that the hemoglobin, uric acid and creatinine of male patients were higher than those of female patients (all P<0.05), but the estimated glomerular filtration rate (eGFR) and urinary protein had no statistical significance (all P>0.05). Women with blood type A and O were heavier than men under microscope. The pathological manifestations of M, E, S and C lesions in women with type A blood were heavier than those in men, and S and T lesions in men with type B blood were heavier than those in women. There was no significant difference in the general baseline data, inflammation and kidney indexes between the four groups of men and women (all P>0.05). Pathologically, the M lesions of men with B blood group were more severe than those of other blood groups, while the S and T lesions of women with B blood group were less severe than those of other blood groups. Conclusions:The clinical and pathological manifestations of IgAN women with type A are heavier, the pathological manifestations of IgAN women with type B are lighter, but the pathological lesions of IgAN men with type B are heavier.