The glomerular GCR expression, MEST score and clinical progression in patients with IgAN


Ala Tekin B*, Paydas S, Kaya B, Eren Erdogan K, Binokay H, Sertdemir Y, Balal M and Gonlusen G

Aim: Glucocorticoids are used as the primary treatment in IgA Nephropathy (IgAN), and they manifest their effects by binding to intracellular glucocorticoid receptors. Studies have shown that Glucocorticoid Receptor Expression (GCR) expression correlates with steroid response in various diseases. Our aim was to evaluate the glomerular GCR expression, MEST score and clinical progression in patients with IgAN.

Materials and methods: This study included 103 patients (58 male) with biopsy proven primary IgAN, who were treated with angiotensin converting enzyme inhibitor/angiotensin receptor blocker and methyl prednisolone and followed-up between 2002-2019. GCR expression determined immunohistochemically, MEST score, clinical and laboratory parameters of the patients were evaluated from the beginning of IgAN diagnosis.

Results: Mean age was 40,79 ± 12. Demographic and laboratory data were similar according to GCR staining rate. In patients with meningeal proliferation (M1) GCR was stained more intensely than those with M0. At baseline Glomerular Filtration (GFR) (↑) and proteinuria (↓) were statistically significant different in patients with T0 or E0 compared to patients with T1 or E1. Systolic Blood Pressure (BP) was significantly higher in E1 patients. At diagnosis increased systolic and diastolic BP, increased counts of White Blood Cell (WBC) and neutrophil, increased levels of parathormone, BUN, creatinine, uric acid, potassium, magnesium, total cholesterol, LDL, elevated sclerosis rate, decreased total protein level, decreased GFR level were found to be poor prognostic factors in our study.

Conclusion: Any correlation was not found between the rate of GCR staining and clinical and biochemical parameters in patients with Ian, M1 was higher in those with high GCR expression. Patients with high proteinuria, low GFR, and high blood pressure at baseline and 6. Month had higher MEST scores. Larger studies are needed to evaluate the effect of GCR expression in the treatment or clinical course of IgAN.

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