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IgA nephropathy (IgAN) is the leading cause of end-stage renal disease, although its mechanisms remain incompletely understood. Previous studies have identified metabolites associated with IgAN, but their causal relationships require further investigation. This study employed a 2-sample Mendelian randomization (MR) approach to assess the causal relationships between 1400 serum metabolites and IgAN. Causal effects between these metabolites and IgAN were estimated using the inverse-variance weighted method. Additional analyses, including MR-Egger regression, weighted median, simple mode, and weighted mode methods, were conducted to refine and validate these findings. Pleiotropy and heterogeneity tests were also performed. The initial analysis identified 9 known and 4 novel metabolites associated with IgAN. Notably, Acisoga was found to increase the risk of IgAN, whereas serine exhibited a protective effect; both findings were confirmed by robust statistical tests (P < .05). This initial MR analysis highlights 2 metabolites significantly linked to IgAN, providing valuable insights into the disease' s underlying mechanisms for clinical research. Further investigation is needed to validate these findings.
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http://dx.doi.org/10.1097/MD.0000000000043353 | DOI Listing |
MedComm (2020)
September 2025
Immunoglobulin A nephropathy (IgAN), the most prevalent primary glomerulonephritis globally, is characterized by mesangial IgA deposition and heterogeneous clinical trajectories. Historically, management relied on renin-angiotensin system inhibition and empirical immunosuppression, yet high lifetime kidney failure risk persists despite optimized care. This review synthesizes advances in molecular pathogenesis, highlighting how the traditional multi-hit hypothesis-while foundational for targeted therapy development-fails to capture IgAN's recurrent, self-amplifying nature.
View Article and Find Full Text PDFClin Kidney J
September 2025
Department of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Background: This study aimed to evaluate the efficacy and safety of telitacicept versus mycophenolate mofetil (MMF) in high-risk progressive immunoglobulin A nephropathy (IgAN).
Methods: This retrospective, multicentre cohort study included patients with high-risk progressive IgAN who received telitacicept or MMF therapy, both combined with low-dose steroids. Clinical data were collected from treatment initiation to 12 months.
Infect Drug Resist
September 2025
Department of Emergency, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, Zhejiang, 324000, People's Republic of China.
Introduction: Severe community-acquired pneumonia (SCAP) in immunocompromised patients is often caused by rare atypical pathogens, which are difficult to detect using conventional microbiological tests (CMTs) and can progress to sepsis in severe cases. Metagenomic next-generation sequencing (mNGS), an emerging pathogen detection technique, enables rapid identification of mixed infections and provides valuable guidance for clinical treatment decisions. SCAP-induced sepsis caused by a six-pathogen co-infection has not been previously reported, but interpretation remains a challenge.
View Article and Find Full Text PDFRen Fail
December 2025
Department of Nephrology, National Clinical Key Specialty Construction Program (2023); Institute of Nephrology; Guangdong Provincial Key Laboratory of Autophagy and Major Chronic Non-communicable Diseases; Key Laboratory of Prevention and Management of Chronic Kidney Disease of Zhanjiang City, Affil
Sodium-glucose cotransporter 2 inhibitors reduced proteinuria in patients with IgA nephropathy; however, their efficacy in patients at high risk of progression receiving immunosuppressive agents and renin angiotensin-aldosterone system inhibitors remains unclear. After 3 months of low-dose steroid alone or combined with mycophenolate mofetil, as well as renin angiotensin-aldosterone system inhibitors treatment, 105 biopsy-proven IgA nephropathy patients with proteinuria greater than 0.5 g/d were included in this study.
View Article and Find Full Text PDFClin J Am Soc Nephrol
September 2025
Kidney Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Kidney Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, China.
Background: The Therapeutic Effects of Steroids in IgA Nephropathy Global (TESTING) trial demonstrated that glucocorticoid therapy reduced proteinuria and improved kidney outcomes in patients with Immunoglobulin A Nephropathy (IgAN). Galactose-deficient IgA1 (Gd-IgA1) plays a central role in IgAN pathogenesis by promoting immune complex formation. However, the effects of glucocorticoid on pathogenic IgA levels remain unclear.
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