Work

Clinical significance of the time-average systemic immunoinflammatory index in primary immunoglobulin A nephropathy: a bicentric retrospective cohort study

Year: 2025

Type: article

Abstract: Background: Systemic immune inflammation index (SII) is a potential marker that can reflect the systemic inflammatory response. However, the clinical significance of SII for immunoglobulin A nephropathy (IgAN) has yet to be determined. Methods: This was a retrospective analysis, covering January 2011 to December 2023, involving 1,399 IgAN patients confirmed through renal biopsy. The low TASII (L-TASII) group comprised patients with a time-average SII (TASII) below the top third of the cohort, whereas the high TASII (H-TASII) group included all remaining patients. All patients were matched 1:1 according to age, sex, follow-up time, and baseline estimated glomerular filtration rate (eGFR). Clinical pathology and prognosis were assessed and compared between the two groups. Results: After matching, the L-TASII and H-TASII groups each feature 556 cases. Patients in the H-TASII group had lower albumin levels (36.88 ± 6.24 g/L vs. 37.93 ± 5.45 g/L, p = 0.01) and higher proteinuria levels (2.19 ± 2.25 g/day vs. 1.75 ± 2.07 g/day, p = 0.003). With an eGFR ≥30% when compared with the baseline or end-stage renal disease as the composite endpoint events, Kaplan-Meier curve analysis revealed that after an average follow-up of 59.91 ± 32.42 months, the survival rate was markedly lower in the H-TASII group than in L-TASII group (log-rank p < 0.01). Analysis revealed that TASII levels are independent predictors for the occurrence of endpoint events (hazard ratio, 1.02; 95% confidence interval, 1.01-1.04; p = 0.001). Conclusion: IgAN patients with a high TASII have more serious clinical manifestations such as creatinine, urinary protein, and inflammatory markers, while there is a worse prognosis for patients with low TASII. Thus, the TASII score represents a significant risk factor for adverse renal outcomes in IgAN patients and serves as a reliable predictor of renal survival.

Source: Kidney Research and Clinical Practice

DOI: 10.23876/j.krcp.24.260