Kidney Week

Abstract: SA-PO835

Kidney Prognostic Value of Serum Monoclonal Immunoglobulin in Nonautoimmune Diseases Related to Cryoglobulinemic Glomerulonephritis

Session Information

• C3G, TMA, MGRS, Amyloidosis, and More
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Ma, Lei, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Lei Ma

• Liang, Dandan, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Dandan Liang, MD

• Xia, Yuanyuan, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Yuanyuan Xia

• Xu, Feng, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Feng Xu

• Liang, Shaoshan, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Shaoshan Liang

• Chen, Dacheng, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Dacheng Chen

• Yao, Xinchen, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Xinchen Yao

• Yang, Fan, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Fan Yang

• Zhu, Xiaodong, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Xiaodong Zhu

• Zeng, Caihong, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, NanJing, China

Caihong Zeng

Background

To explore the clinicopathological features and renal outcome in patients with cryoglobulinemic glomerulonephritis (Cryo-GN) without evidence of autoimmunity disorders.

Methods

Sixty-nine patients with Cryo-GN from a single center were recruited in this retrospective study. Their clinical, pathologic, and follow-up data were collected and analyzed. According to whether the serum monoclonal immunoglobulin (MIg) and HBV-DNA/HBV markers or HCV-RNA/anti-HCV antibodies were positive or not, they were classified into four groups: positive serum MIg only (MIg group), positive HBV-DNA/HBV markers or HCV-RNA/anti-HCV antibodies (HBV/HCV) only (HBV/HCV group), positive serum MIg and HBV/HCV (MIg+HBV/HCV group), and all MIg/HBV/HCV negative group.

Results

The male-to-female ratio was 1.38:1 with a mean age of 50.4±14.7 years in the patient cohort. Hypertension was presented in 59.4% of cases, anemia in 73.9%, renal insufficiency in 58.0%, nephrotic proteinuria in 44.9% and microscopic hematuria in 94.2%. The MIg group had significantly lower eGFR levels, higher cryoglobulin levels, and higher rates of abnormal serum-free light chain ratios than the MIg/HBV/HCV negative group. The most common histological pattern of Cryo-GN was membranoproliferative glomerulonephritis (MPGN), and the MIg group had significantly higher scores of the severity of intracapillary cryo-Plugs than the MIg+HBV/HCV group and the MIg/HBV/HCV negative group. Sixty-three patients had a median follow-up of 31.2 months, and 25.4% of them progressed to end-stage renal disease (ESRD). The renal survival was inferior for MIg group than for HBV/HCV group. Multivariate analysis showed that serum MIg and the severity of intracapillary cryo-plugs were independent prognostic factors.

Conclusion

Regardless of the presence of HBV/HCV infection, non-autoimmune diseases related Cryo-GN patients with serum MIg had worse renal function and renal survival. Serum MIg and severity of intracapillary cryo-Plugs were independent risk factors for renal survival in Cryo-GN patients without autoimmune diseases.

Funding

• Government Support – Non-U.S.