Oncotarget

Clinical Research Papers:

Elevated serum fibrinogen level is an independent risk factor for IgA nephropathy

Ji Zhang, Chaosheng Chen, Qiongxiu Zhou, Shubei Zheng, Yinqiu Lv, Jianna Zhang, Xiaohan You, Zhanyuan Li, Zhihong Zhou and Min Pan _

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Oncotarget. 2017; 8:99125-99135. https://doi.org/10.18632/oncotarget.21702

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Abstract

Ji Zhang2, Chaosheng Chen2, Qiongxiu Zhou2, Shubei Zheng1, Yinqiu Lv2, Jianna Zhang2, Xiaohan You2, Zhanyuan Li1, Zhihong Zhou1 and Min Pan1

1Department of Nephrology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China

2Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China

Correspondence to:

Min Pan, email: [email protected]

Keywords: IgA nephropathy, fibrinogen, chronic kidney disease, Oxford classification, renal outcome

Received: July 29, 2017     Accepted: September 22, 2017     Published: October 09, 2017

ABSTRACT

Background: IgA nephropathy is a primary cause of renal failure, and inflammation and renal fibrosis are the main mechanisms leading to kidney damage. The serum fibrinogen level is closely related to inflammatory states, but its relationship to the prognosis of IgA nephropathy (IgAN) is unclear.

Materials and Methods: 1053 patients diagnosed with IgAN after renal biopsy were enrolled from two Nephrology Departments. Demographic and clinical data and histopathological features were collected. The patients were divided into four groups (Q1–Q4) according to the serum fibrinogen levels at the time of renal biopsy, and the relationships of serum fibrinogen levels with other risk factors and the prognosis of IgAN were investigated.

Results: 672 patients with proven primary IgAN were included in this study, which included a median follow-up of 36 months. Patients with higher serum fibrinogen levels had elevated serum creatinine levels, 24-hour urinary protein, and blood pressure compared with patients with the lowest levels of serum fibrinogen as well as severe renal damage at the time of renal biopsy. Univariate and multivariate Cox regression analyses confirmed that the serum fibrinogen level at the time of renal biopsy was significantly related to the prognosis of patients with IgAN.

Conclusions: In patients with IgAN, an elevated serum fibrinogen level at the time of renal biopsy is associated with poor renal outcomes, which suggests the need for more aggressive early interventions. Greater benefits of aggressive treatments were observed in patients with higher serum fibrinogen levels.


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