Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy
Introduction. The identification of reliable prognostic factors is a crucial requirement for patients with IgA nephropathy (IgAN). Here, we explored the relationship between serum chloride levels and prognosis in patients with IgAN. Methods. We recruited all patients with primary IgAN, as diagnosed...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-01-01
|
| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2021/3598135 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850176238250885120 |
|---|---|
| author | Yaling Zhai Xingchen Yao Yuanyuan Qi Jingge Gao Yazhuo Chen Xinnian Wang Feng Wu Zhanzheng Zhao |
| author_facet | Yaling Zhai Xingchen Yao Yuanyuan Qi Jingge Gao Yazhuo Chen Xinnian Wang Feng Wu Zhanzheng Zhao |
| author_sort | Yaling Zhai |
| collection | DOAJ |
| description | Introduction. The identification of reliable prognostic factors is a crucial requirement for patients with IgA nephropathy (IgAN). Here, we explored the relationship between serum chloride levels and prognosis in patients with IgAN. Methods. We recruited all patients with primary IgAN, as diagnosed by renal biopsy, between 1st January 2015 and 1st April 2019. Patients were divided two groups (high chloride group and low chloride group) based on the best cut-off values from survival receiver operating characteristic (ROC) curves. The baseline clinicopathological characteristics of two groups were then compared. Cox proportional hazard models were used to determine the prognostic value of serum chloride levels in patients with IgAN. Finally, we screened reliable prognostic indicators and built a clinical prediction model and validated the performance of the model. Results. Compared with patients in the high chloride group, patients in the low chloride group had significantly lower levels of 24-hour urinary total protein (24 h-UTP), serum creatinine (sCr), and higher levels of hemoglobin (Hb), albumin (all p<0.05), and less proportion of Oxford classification grade E1 (endothelial cell proliferation) and T2 (renal tubule atrophy or renal interstitial fibrosis). Cox analysis revealed that serum chloride level≥105.4 mmol/L was a significant and independent risk factor for prognosis in patients with IgAN (p<0.05). Serum chloride, sCr, T, hypertension, and Hb were used to generate a predictive model for prognosis. Thec-indices of our predictive model were 0.80, 0.86, and 0.78, for 1, 2, and 3 years, respectively; Brier scores were 0.06, 0.09, and 0.16, respectively. Conclusions. A serum chloride level≥105.4 mmol/l was identified as a significant and independent risk factor for the prognosis of patients with IgAN. A predictive prognosis model was generated using serum chloride, sCr, T, hypertension, and Hb; this model exhibited a good predictive effect. |
| format | Article |
| id | doaj-art-b098e083271f4e6fb9257daeb8c06719 |
| institution | OA Journals |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-b098e083271f4e6fb9257daeb8c067192025-08-20T02:19:18ZengWileyJournal of Immunology Research2314-88612314-71562021-01-01202110.1155/2021/35981353598135Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA NephropathyYaling Zhai0Xingchen Yao1Yuanyuan Qi2Jingge Gao3Yazhuo Chen4Xinnian Wang5Feng Wu6Zhanzheng Zhao7Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaIntroduction. The identification of reliable prognostic factors is a crucial requirement for patients with IgA nephropathy (IgAN). Here, we explored the relationship between serum chloride levels and prognosis in patients with IgAN. Methods. We recruited all patients with primary IgAN, as diagnosed by renal biopsy, between 1st January 2015 and 1st April 2019. Patients were divided two groups (high chloride group and low chloride group) based on the best cut-off values from survival receiver operating characteristic (ROC) curves. The baseline clinicopathological characteristics of two groups were then compared. Cox proportional hazard models were used to determine the prognostic value of serum chloride levels in patients with IgAN. Finally, we screened reliable prognostic indicators and built a clinical prediction model and validated the performance of the model. Results. Compared with patients in the high chloride group, patients in the low chloride group had significantly lower levels of 24-hour urinary total protein (24 h-UTP), serum creatinine (sCr), and higher levels of hemoglobin (Hb), albumin (all p<0.05), and less proportion of Oxford classification grade E1 (endothelial cell proliferation) and T2 (renal tubule atrophy or renal interstitial fibrosis). Cox analysis revealed that serum chloride level≥105.4 mmol/L was a significant and independent risk factor for prognosis in patients with IgAN (p<0.05). Serum chloride, sCr, T, hypertension, and Hb were used to generate a predictive model for prognosis. Thec-indices of our predictive model were 0.80, 0.86, and 0.78, for 1, 2, and 3 years, respectively; Brier scores were 0.06, 0.09, and 0.16, respectively. Conclusions. A serum chloride level≥105.4 mmol/l was identified as a significant and independent risk factor for the prognosis of patients with IgAN. A predictive prognosis model was generated using serum chloride, sCr, T, hypertension, and Hb; this model exhibited a good predictive effect.http://dx.doi.org/10.1155/2021/3598135 |
| spellingShingle | Yaling Zhai Xingchen Yao Yuanyuan Qi Jingge Gao Yazhuo Chen Xinnian Wang Feng Wu Zhanzheng Zhao Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy Journal of Immunology Research |
| title | Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy |
| title_full | Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy |
| title_fullStr | Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy |
| title_full_unstemmed | Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy |
| title_short | Elevated Serum Chloride Levels Contribute to a Poor Prognosis in Patients with IgA Nephropathy |
| title_sort | elevated serum chloride levels contribute to a poor prognosis in patients with iga nephropathy |
| url | http://dx.doi.org/10.1155/2021/3598135 |
| work_keys_str_mv | AT yalingzhai elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT xingchenyao elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT yuanyuanqi elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT jinggegao elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT yazhuochen elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT xinnianwang elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT fengwu elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy AT zhanzhengzhao elevatedserumchloridelevelscontributetoapoorprognosisinpatientswithiganephropathy |