As a library, NLM provides access to scientific literature. Inclusion in an NLM database does not imply endorsement of, or agreement with,
the contents by NLM or the National Institutes of Health.
Learn more:
PMC Disclaimer
Efficacy of plasma exchange in severe crescentic IgA nephropathy: A multicentered, cohort study
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
1
北京大学第一医院肾内科，北京大学肾脏疾病研究所，卫生部肾脏疾病重点实验室，慢性肾脏病防治教育部重点实验室(北京大学)，中国医学科学院免疫介导肾病诊治创新单元，北京 100034, Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Research Units of Diagnosis and Treatment of lmmune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100191, China
2
郑州大学附属第一医院肾内科，郑州 450052, Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
3
北京大学人民医院肾内科，北京 100044, Department of Nephrology, Peking University People's Hospital, Beijing 100044, China
4
北京大学第三医院肾内科，北京 100191, Department of Nephrology, Peking University Third Hospital, Beijing 100191, China
5
中日友好医院肾内科，北京 100029, Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China
6
首都医科大学附属北京安贞医院肾内科，北京 10029, Division of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing 10029, China
7
中国人民解放军总医院肾内科，北京 100853, Department of Nephrology, Chinese PLA General Hospital, Beijing 100853, China
8
河北医科大学第二医院肾内科，石家庄 050000, Renal Division, Department of Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
9
山西医科大学第二医院肾内科，太原 030001, Renal Division, Shanxi Medical University Second Affiliated Hospital, Taiyuan 030001, China
共纳入95例新月体型IgA肾病伴急性肾病(acute kidney disease, AKD)患者，其中37例患者接受了血浆置换治疗，58例患者接受常规强化免疫抑制治疗。整体人群肾活检时估算肾小球滤过率(estimated glomerular filtration rate, eGFR)[
M
(
P
25
,
P
75
)]12.77 (7.28, 21.29) mL/(min·1.73 m
2
)，24-h尿蛋白定量5.9 (4.0, 8.9) g，新月体百分比为64.71%(54.55%, 73.68%)。倾向性评分匹配共23对患者，中位随访时间7 (1, 26) 个月，共29例(63.0%)患者进入终末期肾病, 其中血浆置换治疗组16例(69.6%)，常规强化免疫抑制治疗组13例(56.5%)。两组患者基线eGFR[14.30(9.31~17.58) mL/(min·1.73 m
2
)
vs
. 11.45(5.59~20.79) mL/(min·1.73 m
2
)]、24-h尿蛋白定量[(7.4±3.4) g
vs
. (6.6±3.8) g]、新月体百分比(64.49%±13.23%
vs
. 66.41%±12.65%)、肾活检后应用激素治疗比例[23(100.0%)
vs
. 21(91.3%)] 比较，差异均无统计学意义(
P
均>0.05)。Kaplan-Meier生存分析结果示生存率组间比较，差异无统计学意义(Log-rank检验，
P
=0.933)。
结论
在常规强化免疫抑制治疗的基础上加用血浆置换治疗未能进一步改善新月体型IgA肾病预后。
Keywords:
肾小球肾炎, IgA肾病, 新月体肾小球肾炎, 血浆置换
Abstract
Objective
To evaluate the efficacy of plasma exchange therapy on crescentic IgA nephropathy (IgAN).
Methods
A retrospective analysis was performed in a cohort of patients with crescentic IgAN from January 2012 to September 2020 at 9 sites across China. Clinical and pathological data, as well as therapeutic regimens, were collected. In order to minimize the effect of potential confounders in baseline characteristics, propensity score matching using a 1 ∶1 ratio nearest neighbor algorithm was performed between the adjunctive plasma exchange therapy group and the intensive immunosuppressive therapy group. The primary outcome was end-stage of kidney disease (ESKD). Kaplan-Meier method was used to compare the difference in renal survival between the two groups.
Results
A total of 95 crescentic IgAN patients with acute kidney disease were included in this study, including 37 (38.9%) patients receiving adjunctive plasma exchange therapy, and 58 (61.1%) patients receiving intensive immunosuppressive therapy. In the whole cohort, the baseline eGFR was 12.77 (7.28, 21.29) mL/(min·1.73 m
2
), 24-hour urinary protein quantification was 5.9 (4.0, 8.9) g, and crescent percentage was 64.71% (54.55%, 73.68%). In the study, 23 patients in each group were matched after propensity score matching The median follow-up time was 7 (1, 26) months. As a whole, 29 patients (63.0%) reached ESKD, including 16 patients (69.6%) in the adjunctive plasma exchange therapy group and 13 (56.5%) patients in the intensive immunosuppressive therapy group.. There were no stastical difference between the two groups in terms of baseline eGFR [14.30 (9.31, 17.58) mL/(min·1.73 m
2
)
vs.
11.45 (5.59, 20.79) mL/(min·1.73 m
2
)], 24-hour urinary protein (7.4±3.4) g
vs.
(6.6±3.8) g, crescent percentage 64.49%±13.23%
vs.
66.41%±12.65% and the proportion of patients received steroid therapy[23 (100.0%)
vs
. 21 (91.3%)] (All
P
>0.05). Kaplan-Meier survival analysis demonstrated that there was no significant difference in renal survival rate between the two groups (Log-rank test,
P
=0.933).
Conclusion
The adjunctive plasma exchange therapy in addition to conventional intense immunosuppressive therapy did not additionally improve the prognosis of crescentic IgA nephropathy.
Keywords:
Glomerulonephritis, IgA nephropathy, Crescentic glomerulonephritis, Plasma exchange therapy
使用SPSS(version 22.0, IBM Corp., Armonk, NY)，作图采用R(version 4.0.2)软件，正态分布的计量资料以
x
±
s
表示，非正态分布计量资料采用
M
(
P
25
，
P
75
)表示，定性资料采用频数(频率)表示。正态分布的计量资料组间比较采用独立样本
t
检验，非正态分布者组间比较采用Mann-Whitney
U
非参数检验，分类资料组间比较采用
χ
2
检验或Fisher精确概率计算法。本研究采用倾向性评分的方法减少组间差异，首先以是否应用血浆置换治疗为因变量，各协变量为自变量，通过Logistic回归估计倾向性评分值。采用1 ∶1最邻近匹配法进行匹配，匹配过程定义卡钳值为0.02。匹配过程纳入的变量为性别、年龄、肾活检前出现少尿或无尿、肾活检前接受透析治疗、肾活检时MAP、eGFR、24-h尿蛋白定量、新月体百分比以及肾活检后接受激素治疗，在完成匹配、组间均衡后进一步分析。生存资料应用Kaplan-Meier生存分析方法计算各组肾存活率，统计分析采用Log-rank检验。主要终点比较采用Cox回归分析计算
HR
值，次要终点分析采用比值比(
OR
)计算得出，
P
< 0.05认为差异有统计学意义。
在37例接受血浆置换患者中，19例(51.4%)肾活检时需要透析治疗，显著高于常规强化免疫抑制治疗组患者(11/58, 19.0%，
P
=0.001)。此外，与常规强化免疫抑制治疗组相比，血浆置换组患者的中位eGFR水平[9.38 mL/(min· 1.73m
2
)
vs
. 16.06 mL/(min· 1.73m
2
)，
P
=0.035]和C3水平(0.74 g/L
vs.
0.86 g/L，
P
=0.008)较低，表明血浆置换组患者病情较重。中位随访时间9.7(0.5~27.3)个月，血浆置换组37例患者中有29例(78.4%)发生ESKD，而常规强化免疫抑制治疗组58例患者中有24例(41.4%)发生ESKD (Log-rank检验；
P
< 0.001)。
2.2. 倾向性评分匹配后患者临床及病理特征
进一步通过倾向性评分匹配法减少血浆置换组与常规强化免疫抑制治疗组的组间不平衡性(
表 2
)，共23对患者匹配成功。匹配后的46例病例基线平均MAP为(110.3±11.7) mmHg，尿红细胞计数为466.4(141.8~1 390.5) /μL，平均血红蛋白水平为(103.8±21.6) g/L，eGFR水平为12.74(7.27~18.85) mL/(min·1.73m
2
)。新月体的平均百分比为64.3%。患者的血浆置换联合治疗组和常规强化免疫抑制治疗组的主要实验室检查和确诊后治疗情况差异无统计学意义。肾活检前，与常规强化免疫抑制治疗组相比，血浆置换联合治疗组接受激素(52.2%
vs
. 17.4%，
P
=0.014)和环磷酰胺(26.1%
vs
. 4.3%，
P
=0.042)治疗的患者更多。血浆置换联合治疗组所有患者和常规强化免疫抑制治疗组中91.3%的患者接受了口服激素治疗，每组各有17例(73.9%)患者接受静脉激素冲击治疗。在血浆置换联合治疗组和常规强化免疫抑制治疗组的23名患者中，各有13例(56.5%)、10例(43.5%)患者接受了环磷酰胺治疗(
表 2
)。
新月体型IgA肾病队列倾向性评分匹配后患者信息
Demographic and clinical characteristics of 46 patients with crescentic IgA nephropathy after PSM
Items
Total population
(
n
=46)
PLEX+IS group
(
n
=23)
IS group
(
n
=23)
PSM, propensity score matching; PLEX, plasma exchange therapy; IS, immunosuppressants; RB, renal biopsy; ACEi/ARB, angiotensin, converting enzyme inhibitor/angiotensin receptor blocker; MAP, mean arterial pressure; Hb, hemoglobin; ESR, erythrocyte sedimentation rate; RBC, red blood cell; Scr, serum creatinine; eGFR, estimated glomerular filtration rate; Alb, albumin; CRP, C, reactive protein; Total crescents, cellular crescents + fibrocellular crescents + fibrous crescents.
Age/years,
x
±
s
38±18
37±18
39±19
0.769
Male/%
31 (67.4)
16 (69.6)
15 (65.2)
0.753
Time of follow-up/months,
M
(
P
25
,
P
75
)
7 (1，26)
9 (3，27)
2 (0，22)
0.212
Course of disease/months,
M
(
P
25
,
P
75
)
2.0 (1.0，6.3)
4.0 (1.0，12.0)
2.0 (1.0，5.0)
0.073
Prodromic infection/%
17 (37.0)
9 (39.1)
8 (34.8)
0.760
Auria or oligouria/%
5 (10.9)
3 (13.0)
2 (8.7)
0.639
Gross hematuria/%
12 (26.1)
4 (17.4)
8 (34.8)
0.184
Hypertension history/%
34 (73.9)
19 (82.6)
15 (65.2)
0.184
Dialysis prior to RB/%
13 (28.3)
6 (26.1)
7 (30.4)
0.743
ACEi/ARB use prior to RB/%
9 (19.6)
6 (26.1)
3 (13.0)
0.270
Steroids use prior to RB/%
16 (34.8)
12 (52.2)
4 (17.4)
0.014
IS use prior to RB/%
7 (15.2)
6 (26.1)
1 (4.3)
0.042
MAP/mmHg,
x
±
s
110.3±11.7
109.9±12.2
110.7±11.4
0.813
Hb/(g/L),
x
±
s
103.8±21.6
107.2±16.7
100.5±25.6
0.296
ESR/(mm/h),
M
(
P
25
,
P
75
)
45.4±22.2
45.7±21.9
44.4±24.8
0.901
Urine RBC/(/μL),
M
(
P
25
,
P
75
)
466.4 (141.8，1 390.5)
554.4 (140.1，1 728.9)
457.0 (134.0，1 000.0)
0.733
24-hour proteinuria/g,
M
(
P
25
,
P
75
)
7.0±3.6
7.4±3.4
6.6±3.8
0.502
Scr/(μmol/L),
M
(
P
25
,
P
75
)
377.6 (283.3，633.7)
352.8 (309.0，522.3)
451.0 (258.7，775.0)
0.374
eGFR/[mL/(min·1.73m
2
)],
M
(
P
25
,
P
75
)
12.74 (7.27，18.85)
14.30 (9.31，17.58)
11.45 (5.59，20.79)
0.318
Alb/(g/L),
M
(
P
25
,
P
75
)
28.3±5.6
27.8±5.5
28.7±5.8
0.627
IgG/(g/L),
M
(
P
25
,
P
75
)
7.12(5.74，10.30)
7.13(5.71，10.42)
6.41(5.00，10.01)
0.849
IgA/(g/L),
M
(
P
25
,
P
75
)
2.86(2.04，3.54)
2.79(1.70，3.69)
3.00(2.13，3.45)
0.107
IgM/(g/L),
M
(
P
25
,
P
75
)
0.75±0.32
0.76±0.34
0.74±0.31
0.864
C3/(g/L),
M
(
P
25
,
P
75
)
0.83±0.26
0.78±0.26
0.89±0.24
0.165
C4/(g/L),
M
(
P
25
,
P
75
)
0.26±0.09
0.25±0.08
0.27±0.11
0.525
CRP/(g/L),
M
(
P
25
,
P
75
)
6.68±7.15
6.89±6.50
6.28±8.58
0.823
Global sclerosis/%,
M
(
P
25
,
P
75
)
0(0，8.33)
0(0，10.00)
0(0，7.69)
0.694
Ischemic sclerosis/%,
M
(
P
25
,
P
75
)
8.82±9.97
8.11±10.03
9.54±10.07
0.484
Crescents/%,
M
(
P
25
,
P
75
)
65.45±12.83
64.49±13.23
66.41±12.65
0.617
Total crescents/%,
M
(
P
25
,
P
75
)
71.08±13.00
71.03±14.04
71.12±12.20
0.981
ACEi/ARB use post to RB,
n
(%)
9 (19.6)
6 (26.1)
3 (13.0)
0.270
Steroids use post to RB,
n
(%)
44 (95.7)
23 (100.0)
21 (91.3)
0.153
Steroid impulse post to RB,
n
(%)
34 (73.9)
17 (73.9)
17 (73.9)
1.000
IS use post to RB,
n
(%)
23 (51.1)
13 (59.1)
10 (43.5)
0.295
与未接受血浆置换治疗患者相比，接受血浆置换联合治疗的患者在前6个月(
OR
=0.867；95%
CI
：0.544~1.382)
和12个月(
OR
=1.000；95%
CI
：0.602~1.660)发生ESKD事件风险差异均无统计学意义(
表 3
)。
血浆置换联合疗法治疗新月体型IgA肾病患者有效性分析
Efficacy of PLEX on primary and secondary outcomes
Outcomes
PLEX+IS group,
n
(%)
IS group,
n
(%)
HR
(95%
CI
)
PLEX, plasma exchange therapy; IS, immunosuppressants; ESKD, end-stage kidney disease. *
P
was calculated using survival analysis (
HR)
；Other
P
values were caculated using Pearson
χ
2
or Fisher exact tests.
Primary outcomes
对于肾活检时已经进入透析的患者(
n
=13)，研究评估了患者在第3个月和第12个月的脱离透析率，观察到在前3个月接受血浆置换联合治疗的患者与常规强化免疫抑制治疗组患者之间差异无统计学意义(
OR
=1.429；95%
CI
：0.565~3.611；
P
=0.447)，在12个月结束时观察到类似结果(
OR
=1.029；95%
CI
：0.64~1.643；
P
=0.909，
表 3
)。
2.4. 血浆置换联合治疗新月体型IgA肾病landmark分析
接受血浆置换治疗患者组发生复合终点风险随时间变化同对照组相比并非恒定，而是在随访约12个月处存在明显改变(
图 2
)。进一步采用landmark分析血浆置换联合疗法在不同时间段内治疗新月体型IgA肾病患者的有效性(
图 3
)，联合血浆置换疗法在随访前12月内较常规强化免疫抑制治疗组未观察到显著的改善预后作用(Log-rank检验，
P
=0.641)；在随访超过12个月时，联合血浆置换疗法相对常规强化免疫抑制治疗组也未观察到显著性改善新月体型IgA肾病患者预后作用(Log-rank检验，
P
=0.369)。
血浆置换联合疗法治疗新月体型IgA肾病患者肾生存差异landmark分析
Landmark analysis for the cumulative survival of paients in the PLEX group and the control group
There were no significanly difference betweeen two groups before 12 months and afterwards (Cox-mantel Log-rank test,
P
=0.641,
P
=0.369). PLEX, plasma exchange therapy.
Supported by the National Natural Science Foundation of China (81322009, 81270795) and the Clinical Characteristic Applied Research Fund of Capital (Z161100000516005)
References
1.
Cattran DC, Feehally J, Cook HT, et al. Kidney disease: Improving global outcomes (KDIGO) glomerulonephritis work group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Int. 2012;2(2):139–274. doi: 10.1038/kisup.2012.9.
[
DOI
] [
Google Scholar
]
2.
Kidney disease: Improving global outcomes (KDIGO) glomerular diseases work group KDIGO 2021 Clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021;100(Suppl 4):S1–S276. doi: 10.1016/j.kint.2021.05.021.
[
DOI
] [
PubMed
] [
Google Scholar
]
3.
Lv J, Yang Y, Zhang H, et al. Prediction of outcomes in crescentic IgA nephropathy in a multicenter cohort study. J Am Soc Nephrol. 2013;24(12):2118–2125. doi: 10.1681/ASN.2012101017.
[
DOI
] [
PMC free article
] [
PubMed
] [
Google Scholar
]
4.
Le vy, Jeremy B. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med. 2001;134(11):1033–1042. doi: 10.7326/0003-4819-134-11-200106050-00009.
[
DOI
] [
PubMed
] [
Google Scholar
]
5.
Jayne DR, Gaskin G, Rasmussen N, et al. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol. 2007;18(7):2180–2188. doi: 10.1681/ASN.2007010090.
[
DOI
] [
PubMed
] [
Google Scholar
]
6.
Suzuki H, Kiryluk K, Novak J, et al. The Pathophysiology of IgA nephropathy. J Am Soc Nephrol. 2011;22(10):1795–1803. doi: 10.1681/ASN.2011050464.
[
DOI
] [
PMC free article
] [
PubMed
] [
Google Scholar
]
7.
Chambers ME, McDonald BR, Hall FW, et al. Plasmapheresis for crescentic IgA nephropathy: A report of two cases and review of the literature. J Clin Apher. 1999;14(4):185–187. doi: 10.1002/(SICI)1098-1101(1999)14:4<185::AID-JCA6>3.0.CO;2-K.
[
DOI
] [
PubMed
] [
Google Scholar
]
8.
Roccatello D, Ferro M, Coppo R, et al. Report on intensive treatment of extracapillary glomerulonephritis with focus on cresentic IgA nephropathy. Nephrol Dial Transplant. 1995;10(11):2054–2059.
[
PubMed
] [
Google Scholar
]
9.
Fujinaga S, Ohtomo Y, Umino D, et al. Plasma exchange combined with immunosuppressive treatment in a child with rapidly progressive IgA nephropathy. Pediatr Nephrol. 2007;22(6):899–902. doi: 10.1007/s00467-006-0428-4.
[
DOI
] [
PubMed
] [
Google Scholar
]
10.
Xie X, Lv J, Shi S, et al. Plasma exchange as an adjunctive therapy for crescentic IgA nephropathy. Am J Nephrol. 2016;44(2):141–149. doi: 10.1159/000448767.
[
DOI
] [
PubMed
] [
Google Scholar
]
11.
Padmanabhan A, Connelly-Smith L, Aqui N, et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence based approach from the writing committee of the american society for apheresis: The eighth special issue. J Clin Apher. 2019;34(3):171–354. doi: 10.1002/jca.21705.
[
DOI
] [
PubMed
] [
Google Scholar
]
12.
Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368(25):2402–2414. doi: 10.1056/NEJMra1206793.
[
DOI
] [
PubMed
] [
Google Scholar
]
13.
Yu G, Zhang Y, Meng B, et al. O-glycoforms of polymeric immunoglobulin A1 in the plasma of patients with IgA nephropathy are associated with pathological phenotypes. Nephrol Dial Transplant. 2021;37(1):33–41. doi: 10.1093/ndt/gfab204.
[
DOI
] [
PubMed
] [
Google Scholar
]
14.
Yamazaki Y, Mori A, Nomura Y, et al. A case of rapidly progressive IgA nephropathy with transient hypocomplementemia at onset. Nihon Jinzo Gakkai Shi. 1997;39(7):765–770.
[
PubMed
] [
Google Scholar
]
15.
Coppo R, Basolo B, Roccatello D, et al. Immunological monitoring of plasma exchange in primary IgA nephropathy. Artif Organs. 2010;9(4):351–360. doi: 10.1111/j.1525-1594.1985.tb04400.x.
[
DOI
] [
PubMed
] [
Google Scholar
]
16.
Lai KN, Lai FM, Leung AC, et al. Plasma exchange in patients with rapidly progressive idiopathic IgA nephropathy: A report of two cases and review of literature. Am J Kidney Dis. 1987;10(1):66–70. doi: 10.1016/S0272-6386(87)80014-8.
[
DOI
] [
PubMed
] [
Google Scholar
]
17.
Wang Z, Jiang Y, Chen P, et al. The level of urinary C4d is associated with disease progression in IgA nephropathy with glomerular crescentic lesions: A cohort study[J]. Nephrol Dial Transplant, 2022[2022-06-01]. https://academic.oup.com/ndt/advance-article-abstract/doi/10.1093/ndt/gfac024/6519273?redirectedFrom=fulltext&login=false
18.
Rosenblad T, Rebetz J, Johansson M, et al. Eculizumab treatment for rescue of renal function in IgA nephropathy. Pediatr Nephrol. 2014;29(11):2225–2228. doi: 10.1007/s00467-014-2863-y.
[
DOI
] [
PubMed
] [
Google Scholar
]
19.
Troels R, Bang P B, Giedrius S, et al. Use of eculizumab in crescentic IgA nephropathy: Proof of principle and conundrum. Clin Kidney J. 2015;8(5):489–491. doi: 10.1093/ckj/sfv076.
[
DOI
] [
PMC free article
] [
PubMed
] [
Google Scholar
]
20.
Matsumura D, Tanaka A, Nakamura T, et al. Coexistence of atypical hemolytic uremic syndrome and crescentic IgA nephropathy treated with eculizumab: A case report. Clin Nephrol Case Stud. 2016;4:24–28. doi: 10.5414/CNCS108889.
[
DOI
] [
PMC free article
] [
PubMed
] [
Google Scholar
]
21.
Lafayette RA, Rovin BH, Reich HN, et al. Safety, tolerability and efficacy of narsoplimab, a novel MASP-2 inhibitor for the treatment of IgA nephropathy. Kidney Int Rep. 2020;5(11):2032–2041. doi: 10.1016/j.ekir.2020.08.003.
[
DOI
] [
PMC free article
] [
PubMed
] [
Google Scholar
]
Articles from Journal of Peking University (Health Sciences) are provided here courtesy of
Editorial Office of Beijing Da Xue Xue Bao Yi Xue Ban, Peking University Health Science Center
