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Research article
Hajeong Lee
Seoul National University College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1873-1587
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited.
Methods
In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used.
Results
A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 1.09-6.98; P=0.03).
Conclusions
In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.
Keywords
Transplantation, allograft, IgA nephropathy, renin-angiotensin-aldosterone system, ACE inhibitors, angiotensin receptor blockade, proteinuria
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CURRENT STATUS: Published
View the published article at BMC Nephrology.
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Editorial decision: Accept
On 27 Aug, 2019
Editor assigned
On 26 Aug, 2019
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On 25 Aug, 2019
Editor invited
On 25 Aug, 2019
Version 1
Posted 03 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 23 Aug, 2019
Editor assigned
On 21 Jul, 2019
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On 20 Jul, 2019
Editor invited
On 01 Jul, 2019
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Subject Areas
Urology & Nephrology
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A new preprint design is coming!
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See the published version of this preprint at BMC Nephrology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Hajeong Lee
Seoul National University College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1873-1587
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Nephrology.
No community comments so far
Editorial decision: Accept
On 27 Aug, 2019
Editor assigned
On 26 Aug, 2019
Submission checks complete
On 25 Aug, 2019
Editor invited
On 25 Aug, 2019
Version 1
Posted 03 Jul, 2019
No comments provided
Editorial decision: Minor revision
On 23 Aug, 2019
Editor assigned
On 21 Jul, 2019
Submission checks complete
On 20 Jul, 2019
Editor invited
On 01 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Urology & Nephrology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Nephrology.
Background
Although immunoglobulin A nephropathy (IgAN) is associated with a high risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited.
Methods
In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and consequent 5-year death-censored-graft-failure (DCGF). The mixed effect model and cox regression analysis were used.
Results
A total of 464 allograft IgAN patients were included: 272, 38, 33, and 121 patients in the no antihypertensive medication, single agent RAASB, single agent beta blocker (BB)/calcium channel blocker (CCB), and combination therapy groups, respectively. High-degree albuminuria after 6 months of allograft IgAN diagnosis was an important prognostic parameter and a partial mediator for the association between the subgroups and 5-year DCGF. The usage of single RAASB was associated with decrement of albuminuria from allograft diagnosis (P for interaction = 0.03). The single BB/CCB group demonstrated significantly worse prognosis than the single RAASB group (adjusted hazard ratio, 2.76 1.09-6.98; P=0.03).
Conclusions
In conclusion, RAASB may be beneficial for graft prognosis in early allograft IgAN patients who require single antihypertensive medication therapy, by means of reducing albuminuria. Further investigation of treatment strategy in allograft IgAN is warranted.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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