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1、Lietal.BMCNephrology(2016)17:164DOI10.1186/s12882-016-0378-4RESEARCHARTICLEOpenAccessVitaminDdeficiencymaypredictapooreroutcomeofIgAnephropathyXiao-HuaLi,Xin-PingHuang,LingPan,Cheng-YuWang,JuQin,Feng-WeiNong,Yu-ZhenLuo,YueWu,*Yu-MingHuang,XiPeng,Zhen-HuaYangandYun-HuaLiaoAbstractBack
2、ground:Experimentalstudiesshowedthat25-hydroxy-vitaminD[25(OH)D]deficiency(definedas25-hydroxy-vitaminD<15ng/ml)hasbeenassociatedwithCKDprogression.PatientswithIgAnephropathyhaveanexceptionallyhighrateofsevere25(OH)Ddeficiency;however,itisnotknownwhetherthisdeficiencyisariskfactorfor
3、progressionofIgAnephropathy.Weconductedthisstudytoinvestigatetherelationshipbetweentheplasmalevelof25(OH)DandcertainclinicalparametersandrenalhistologiclesionsinthepatientswithIgAnephropathy,andtoevaluatewhetherthe25(OH)DlevelcouldbeagoodprognosticmarkerforIgAnephropathyprogression.M
4、ethods:Atotalof105patientswithbiopsy-provenIgAnephropathywereenrolledbetween2012and2015.Thecirculatingconcentrationof25(OH)Dwasdeterminedusingserumsamplescollectedatthetimeofbiopsy.Theprimaryclinicalendpointwasthedeclineofestimatedglomerularfiltrationrate(eGFR;a30%ormoredeclinecompar
5、edtothebaseline).Results:MeaneGFRdecreasedandproteinuriaworsenedproportionallyascirculating25(OH)Ddecreased(P<0.05).The25(OH)DdeficiencywascorrelatedwithahighertubulointerstitialscorebytheOxfordclassification(P=0.008).Theriskforreachingtheprimaryendpointwassignificantlyhigherinthepat
6、ientswitha25(OH)Ddeficiencycomparedtothosewithahigherlevelof25(OH)D(P=0.001).AsevaluatedusingtheCoxproportionalhazardsmodel,25(OH)Ddeficiencywasfoundtobeanindependentriskfactorforrenalprogression[HR5.99,95%confidenceintervals(CIs)1.59–22.54,P=0.008].Conclusion:A25(OH)Ddeficiencyatbas
7、elineissignificantlycorrelatedwithpoorerclinicaloutcomesandmoreseverrenalpathologicalfeatures,andlowlevelsof25(OH)DatbaselinewerestronglyassociatedwithincreasedriskofrenalprogressioninIgAN.Keywords:Diseaseprogression,IgAnephropathy,Prognosis,Riskfactor,VitaminDBackgroundRecentobserva
8、tionssuggest
