Clinical characteristics and prognosis of IgA nephropathy with predominant light chain deposition
- 1Department of Nephrology, Hangzhou Hospital of Traditional Chinese Medicine (Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University), Hangzhou, China
Abstract
To compare the clinicopathological features, treatment response, and renal outcomes of patients with IgA nephropathy (IgAN) with κ-dominant, κ–λ co-deposition, or λ-dominant light-chain deposition. This retrospective, single-centre cohort study included 105 patients with primary IgAN who underwent their first native-kidney biopsy. Twenty-one patients with κ-dominant deposition were matched to 42 patients with κ–λ co-deposition and 42 patients with λ-dominant deposition based on age, sex, 24-hour urinary protein excretion, and baseline serum creatinine. The final matching ratio was 1:2:2. The primary renal endpoint was a sustained ≥30% increase in serum creatinine from baseline. During a median follow-up of 25 months (IQR, 18–36), 21 patients reached the renal endpoint. Time to treatment response did not differ significantly among the three groups (log-rank p = 0.0707). However, renal progression-free survival differed significantly among the light-chain deposition groups (log-rank p = 0.0046). After adjustment for sex, age, 24-hour urinary protein excretion, and baseline eGFR, a higher κ deposition ratio remained associated with a lower hazard of renal progression (HR [per 1-percentage-point increase] 0.96; 95% CI: 0.94–0.99; p = 0.011). A higher κ light-chain deposition ratio was associated with a lower risk of renal progression in IgAN. κ predominance may be a pathological marker of a distinct and possibly less aggressive immune-complex deposition pattern.
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BibTeX
@article{liu2026clinical,
title = {{Clinical characteristics and prognosis of IgA nephropathy with predominant light chain deposition}},
author = {Xiang Liu and Wenhui He and Xinyu Chen and Hong Liu and Anni Wang and Xuanli Tang and Xue Jiang and Jin Yu},
journal = {Renal Failure},
year = {2026},
month = oct,
doi = {10.1080/0886022x.2026.2745216},
url = {https://doi.org/10.1080/0886022x.2026.2745216},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical characteristics and prognosis of IgA nephropathy with predominant light chain deposition
AU - Xiang Liu
AU - Wenhui He
AU - Xinyu Chen
AU - Hong Liu
AU - Anni Wang
AU - Xuanli Tang
AU - Xue Jiang
AU - Jin Yu
PY - 2026
DA - 2026/10/25
JO - Renal Failure
DO - 10.1080/0886022x.2026.2745216
UR - https://doi.org/10.1080/0886022x.2026.2745216
AB - To compare the clinicopathological features, treatment response, and renal outcomes of patients with IgA nephropathy (IgAN) with κ-dominant, κ–λ co-deposition, or λ-dominant light-chain deposition. This retrospective, single-centre cohort study included 105 patients with primary IgAN who underwent their first native-kidney biopsy. Twenty-one patients with κ-dominant deposition were matched to 42 patients with κ–λ co-deposition and 42 patients with λ-dominant deposition based on age, sex, 24-hour urinary protein excretion, and baseline serum creatinine. The final matching ratio was 1:2:2. The primary renal endpoint was a sustained ≥30% increase in serum creatinine from baseline. During a median follow-up of 25 months (IQR, 18–36), 21 patients reached the renal endpoint. Time to treatment response did not differ significantly among the three groups (log-rank p = 0.0707). However, renal progression-free survival differed significantly among the light-chain deposition groups (log-rank p = 0.0046). After adjustment for sex, age, 24-hour urinary protein excretion, and baseline eGFR, a higher κ deposition ratio remained associated with a lower hazard of renal progression (HR [per 1-percentage-point increase] 0.96; 95% CI: 0.94–0.99; p = 0.011). A higher κ light-chain deposition ratio was associated with a lower risk of renal progression in IgAN. κ predominance may be a pathological marker of a distinct and possibly less aggressive immune-complex deposition pattern.
SN - 1525-6049
SN - 0886-022X
ER -