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Kidney Diseases
By Xinyan Fan, Ming Xia, Lili Wan and 11 others.
IgA nephropathy (IgAN), the most common primary glomerular disease worldwide, carries a poor prognosis when crescent lesions are present. CD9 has been identified as a marker of activated parietal epithelial cells (PECs) in crescentic glomerulonephritis, but its role in IgAN remains largely unexplored.
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We conducted a retrospective cohort study of 47 IgAN patients and analyzed clinical, pathological, and prognostic data. Renal biopsy specimens were immunostained for CD9. The primary endpoint was a ≥15% decline in estimated glomerular filtration rate (eGFR), and the secondary endpoint was 24‑hour proteinuria ≥3.5 g/d. Receiver operating characteristic (ROC) curve analysis, Kaplan‑Meier survival analysis, and Cox proportional hazards regression were performed to evaluate the diagnostic and prognostic value of CD9.
ROC curve analysis showed that CD9 had significant diagnostic value for identifying crescent lesions in IgAN patients (sensitivity 85.7%, specificity 75.0%, p < 0.001). Kaplan‑Meier analysis indicated that higher CD9 expression and crescent proportions of <10% or ≥25% were associated with lower renal survival rates. In multivariable Cox analysis, after adjusting for crescents ≥25%, baseline eGFR, proteinuria, and immunosuppressive therapy, CD9 expression level remained an independent predictor of the primary endpoint (HR 16.45, 95% CI 3.83–70.97; p < 0.001).
CD9 demonstrates significant diagnostic value for identifying crescent lesions in IgAN patients and serves as an independent predictor of eGFR decline. Assessed on renal biopsy tissue, CD9 may be a potential adjunct marker for risk stratification in IgAN patients with crescent lesions.
Published in Kidney Diseases. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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