Table 1.
Clinical, biological, and histological characteristics of 46 patients with cirrhosis-related IgAN
| Characteristics | Cirrhosis-related IgAN N = 46 |
|---|---|
| Clinical features at the time of kidney biopsy | |
| Age (yr) mean±SD | 64 ± 10 |
| Female (%) | 8 (17%) |
| History of hypertension (%) | 27 (59%) |
| History of diabetes (%) | 15 (33%) |
| Tabaco user (%) | 22 (48%) |
| Alcohol abuse (%) | 46 (100%) |
| ACEi or ARB users (%) | 17 (37%) |
| Purpura (%) | 11 (24%) |
| Cirrhosis characteristics at the time of kidney biopsy | |
| Alcoholic only | 29 (63%) |
| Mixed (metabolic and alcohol) | 17 (37%) |
| History of decompensated cirrhosis | 22 (48%) |
| Ascites | 14/22 (64%) |
| Hepatic encephalopathy | 4/22 (18%) |
| Variceal hemorrhage | 8/22 (36%) |
| Spontaneous bacterial ascites | 1/22 (5%) |
| Laboratory findings at the time of kidney biopsy | |
| Serum creatinine (mg/dl) mean±SD | 3.52 ± 2.54 |
| eGFR (MDRD), mean±SD | 36 ± 38 |
| Acute kidney injury (%)a | 34/43 (79%) |
| ICA stage | |
| ICA stage 1 | 7/34 (21%) |
| ICA stage 2 | 7/34 (21%) |
| ICA stage 3 | 20/34 (58%) |
| Alternatives causes of acute kidney injury | 21/34 (62%) |
| Infectious disease | 11 |
| Decompensated cirrhosis | 8b |
| Hypovolemia | 3c |
| Others | 1d |
| Dialysis (%) | 8 (17%) |
| uPCR (g/g) median (IQR) | 2.9 (1.4–4.6) |
| uPCR ≥3 g/g (%) | 21 (46%) |
| Nephrotic syndrome | 14 (30%) |
| Microscopic hematuria (%) | 39 (85%) |
| Macroscopic hematuria (%) | 8 (17%) |
| Low C3 (%) | 7/34 (21%) |
| Low C4 (%) | 5/34 (15%) |
| Histopathological characteristics | |
| Glomeruli (n) mean±SD | 14 ± 7 |
| Sclerotic glomeruli (%) mean±SD | 17 ± 16 |
| MEST-C score, ne | 39 |
| M0/M1, n | 21/18 |
| E0/E1, n | 25/14 |
| S0/S1, n | 25/14 |
| T0/T1/T2, n | 24/11/4 |
| C0/C1/C2, n | 34/3/2 |
| Presence of interstitial infiltrate, n (%) | 25 (54%) |
| Presence of acute tubular necrosis, n (%) | 31 (67%) |
| Vascular lesion, n (%) | 38 (83%) |
| Ischemic glomeruli, n (%) | 19 (41%) |
| Arteriolar hyalinosis, n (%) | 19 (41%) |
| Fibro-intimal thickening, n (%)f | 30/43 (70%) |
| Thrombotic microangiopathy, n (%) | 2 (4%) |
| MPGN pattern, n (%) | 9 (20%) |
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; eGFR, estimated glomerular filtration rate; ICA, international club of ascites; IgAN, IgA nephropathy; IQR, interquartile range; MDRD, Modification of Diet in Renal Disease equation; MPGN, membranoproliferative glomerulonephritis; uPCR, urinary protein-to-creatinine ratio.
Three had missing data on baseline serum creatinine, thus, AKI status and ICA stage could not be determined.
Among the 7 patients with decompensated cirrhosis, 2 had concomitant sepsis.
Hypovolemia; 2 had diarrhea and 1 had rhabdomyolysis.
Postnephrectomy for papillary renal cell carcinoma.
Seven kidney biopsies samples with <8 glomeruli were excluded for the analysis of MEST-C score.
Three patients did not had arteries on kidney biopsy sample.