Global glomerulosclerosis proportions above 10% predict nephropathy progression in IgA Nephropathy: a multicenter retrospective analysis with propensity score matching

Abstract We evaluated the prognostic effect of Global glomerulosclerosis (GS) in the patients with Immunoglobulin A nephropathy (IgAN). In this three-center retrospective study, A total of 1626 IgAN patients were recruited and divided into two groups(GS1 and GS2) based on the median of GS proportion in the study population. The results revealed that, higher GS proportions was associated with higher age, increased amounts of urine protein, decreased eGFR, higher level of serum IgA and C4, lower level of serum IgM, as well as higher score of M, S, T according the Oxford MEST-C classification, and more likely to undergo corticosteroids or RAS blockade therapy. Both in the full and matched cohort, higher GS proportions were found to be independent prognostic factors for the renal survival via Kaplan–Meier (KM) analysis (p < 0.05, p < 0.05, respectively). Additionally, the multivariate Cox regression models identified higher proteinuria, decreased eGFR, higher score of T, higher GS proportions as independent prognostic factors for poor renal outcomes and corticosteroids therapy was a protective indicator of renal outcomes. Lastly, the prediction model based on these prognostic factors were validated to be accurately predict the renal outcome when including GS proportions.