Clinical and Prognostic Factors in Patients with IgG4-Related Kidney Disease - Archive ouverte HAL
Article Dans Une Revue Clinical Journal of the American Society of Nephrology Année : 2023

Clinical and Prognostic Factors in Patients with IgG4-Related Kidney Disease

Anis Chaba
Arnaud Devresse
Vincent Audard
Institut Mondor de Recherche Biomédicale
Jean Jacques Boffa
  • Fonction : Auteur
Alexandre Karras
  • Fonction : Auteur
Claire Cartery
Clément Deltombe
Jonathan Chemouny
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Institut de recherche en santé, environnement et travail
École des Hautes Études en Santé Publique [EHESP]
Claudine Contamin
  • Fonction : Auteur
Cecile Courivaud
  • Fonction : Auteur
Simon Duquennoy
Hugo Garcia
Dominique Joly
  • Fonction : Auteur
Nabila Goumri
  • Fonction : Auteur
Guillaume Hanouna
Jean Michel Halimi
Emmanuelle Plaisier
  • Fonction : Auteur
Mohamed Hamidou
  • Fonction : Auteur
Cédric Landron
  • Fonction : Auteur
David Launay
Institute for Translational Research in Inflammation - U 1286
Celine Lebas
  • Fonction : Auteur
Mathieu Legendre
  • Fonction : Auteur
Agathe Masseau
  • Fonction : Auteur
Alexis Mathian
Lucile Mercadal
Nathalie Morel
Prisca Mutinelli-Szymanski
  • Fonction : Auteur
Sylvain Palat
Jean-Loup Pennaforte
  • Fonction : Auteur
Marie Noelle Peraldi
Agnieszka Pozdzik
  • Fonction : Auteur
Nicolas Schleinitz
Olivier Thaunat
Dimitri Titeca-Beauport
Charlotte Mussini
  • Fonction : Auteur
Sonia Touati
Eric Prinz
  • Fonction : Auteur
Anne Laure Faller
  • Fonction : Auteur
Sarah Richter
  • Fonction : Auteur
Eve Vilaine
  • Fonction : Auteur
Sophie Ferlicot
  • Fonction : Auteur
Clarissa Von-Kotze
  • Fonction : Auteur
Julie Belliere
Jerome Olagne
Rafik Mesbah
Renaud Snanoudj
Mathilde Nouvier
  • Fonction : Auteur
Mikael Ebbo
  • Fonction : Auteur
Mohamad Zaidan
  • Fonction : Auteur correspondant
  • PersonId : 1083645

Connectez-vous pour contacter l'auteur
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]

Résumé

Background IgG4-related kidney disease is a major manifestation of IgG4-related disease, a systemic fibroinflammatory disorder. However, the clinical and prognostic kidney-related factors in patients with IgG4-related kidney disease are insufficiently defined. Methods We conducted an observational cohort study using data from 35 sites in two European countries. Clinical, biologic, imaging, and histopathologic data; treatment modalities; and outcomes were collected from medical records. Logistic regression was performed to identify the possible factors related to an eGFR ≤30 ml/min per 1.73 m 2 at the last follow-up. Cox proportional hazards model was performed to assess the factors associated with the risk of relapse. Results We studied 101 adult patients with IgG4-related disease with a median follow-up of 24 (11–58) months. Of these, 87 (86%) patients were male, and the median age was 68 (57–76) years. Eighty-three (82%) patients had IgG4-related kidney disease confirmed by kidney biopsy, with all biopsies showing tubulointerstitial involvement and 16 showing glomerular lesions. Ninety (89%) patients were treated with corticosteroids, and 18 (18%) patients received rituximab as first-line therapy. At the last follow-up, the eGFR was below 30 ml/min per 1.73 m 2 in 32% of patients; 34 (34%) patients experienced a relapse, while 12 (13%) patients had died. By Cox survival analysis, the number of organs involved (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.01 to 1.55) and low C3 and C4 concentrations (HR, 2.31; 95% CI, 1.10 to 4.85) were independently associated with a higher risk of relapse, whereas first-line therapy with rituximab was protective (HR, 0.22; 95% CI, 0.06 to 0.78). At their last follow-up, 19 (19%) patients had an eGFR ≤30 ml/min per 1.73 m 2 . Age (odd ratio [OR], 1.11; 95% CI, 1.03 to 1.20), peak serum creatinine (OR, 2.74; 95% CI, 1.71 to 5.47), and serum IgG4 level ≥5 g/L (OR, 4.46; 95% CI, 1.23 to 19.40) were independently predictive for severe CKD. Conclusions IgG4-related kidney disease predominantly affected middle-aged men and manifested as tubulointerstitial nephritis with potential glomerular involvement. Complement consumption and the number of organs involved were associated with a higher relapse rate, whereas first-line therapy with rituximab was associated with lower relapse rate. Patients with high serum IgG4 concentrations (≥5 g/L) had more severe kidney disease.

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Sciences du Vivant [q-bio]

Xavier Chard-Hutchinson  : Connectez-vous pour contacter le contributeur

https://hal.science/hal-04227886

Soumis le : mercredi 4 octobre 2023-10:00:56

Dernière modification le : mercredi 18 décembre 2024-16:56:33

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Dates et versions

hal-04227886 , version 1 (04-10-2023)

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Citer

Anis Chaba, Arnaud Devresse, Vincent Audard, Jean Jacques Boffa, Alexandre Karras, et al.. Clinical and Prognostic Factors in Patients with IgG4-Related Kidney Disease. Clinical Journal of the American Society of Nephrology, 2023, ⟨10.2215/CJN.0000000000000193⟩. ⟨hal-04227886⟩

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