The predictive value and response to immunosuppressive therapy of IgA nephropathy patients with crescents in a large retrospective Chinese cohort

Abstract Background The prognostic value and response to immunosuppressive therapy (IST) of patients with crescents in the different backgrounds pathological presentations IgA nephropathy (IgAN) is unclear. Methods 1262 IgAN were enrolled. Crescents (C, 0/1/2), fibrinoid necrosis (FN, 0/1) endocapillary hypercellularity (E, integrated into degrees glomerular activity (0–4 points): mild (0), moderate (1–2), severe (≥ 3). effect IST on score chronic tubular interstitial lesions (T, 0/1/2) analyzed using Cox regression analysis. kidney outcome was defined as eGFR declined ≥ 30% or ESKD. Results C2 an independent risk factor for outcomes (overall cohort: HR 1.85; 95% CI, 1.03–3.31; P = 0.040; T0 patients: 6.52; 2.92–14.54; < 0.001; reference C0) those without IST, while decreased 0.83 (95% 0.54–1.27; 0.396) overall cohort 2.39 1.00–5.67; 0.049) IST. For activity, reduced by 70% (HR 0.30; 0.12–0.74; 0.009; IST) 86% 0.14; CI 0.04–0.54; 0.005; IST). Conclusions could reduce lesion together, well at least one other active including FN E1 lesion.