Analysis Of The Relationship Between Plasma VWF Level And Clinical And Pathological Characteristics Of Patients With IgA Nephropathy

Objective:To investigate the relationship between the level of the plasma Von Willebrand factor(v WF)and the clinical and pathological characteristics of patients with IgA nephropathy(IgAN),and explore its clinical application value.Methods:88 patients with IgA nephropathy and 32 healthy volunteers in the Nephrology Department of Jiangsu Subei People’s Hospital from November 2021 to November 2022 were recruited.Immunoturbidimetry was used to detect the plasma v WF level and analyzed the correlation between plasma v WF and clinical indexes,pathological type and the degree of pathological damage.Results:1.The levels of plasma v WF,serum creatinine and blood urea nitrogen in patients with IgA nephropathy were significantly higher than those in the control group,while the glomerular filtration rate was significantly lower(p<0.05).2.The levels of plasma v WF of 24-hour urinary protein quantitative(24h UPro)≥3g in patients with IgA nephropathy were significantly higher than 24 h UPro<1g group(p<0.05).3.The plasma v WF level of IgA nephropathy patients with CKD stage 3 or above was significantly higher than that of CKD stage 1-2,the difference was statistically significant(p<0.05).4.The levels of blood urea nitrogen,blood β2-microglobulin,cystatin C,cholesterol,and D-dimer in the high plasma v WF group were significantly higher than those in the low plasma v WF group;while albumin was significantly lower than that in the low plasma v WF group(p<0.05).There were no significant differences in creatinine,retinolbinding protein and triglyceride levels(p>0.05).5.In terms of pathological Oxford classification,plasma v WF levels in patients with tubular atrophy/interstitial fibrosis(T1-2)IgA nephropathy were significantly higher than those without tubular atrophy/interstitial fibrosis(T0),which was statistically significant(p<0.05).There were no significant differences in mesangial cell hyperplasia(M),intracapillary hyperplasia(E),segmental glomerulosclerosis(S),or cellular/fibro cellular crescent(C)(p>0.05).Correlation analysis showed that there was a positive correlation between plasma v WF in IgA nephropathy patients and tubular atrophy/interstitial fibrosis in Oxford classification(p<0.05).The area under the ROC curve(AUC)of plasma v WF predicted tubular atrophy/interstitial fibrosis in patients with IgA nephropathy was 0.676,P=0.004.6.In terms of pathological Lee’s grade,the plasma v WF level of in IgA nephropathy patients in Lee’s grade V was higher than that of Lee’s grade II+III(p<0.05),and there was no statistically significant difference between II+III and IV or IV and V(p>0.05).Correlation analysis showed that the plasma v WF was positively correlated with the severity of Lee classification in IgA nephropathy patients(p<0.05).The area under the ROC curve(AUC)of plasma v WF in predicting the pathological severity of IgA nephropathy patients above Lee grade IV was 0.641,p = 0.024.Conclusion:1.The level of plasma v WF in the IgA nephropathy group was significantly higher than that in the control group.2.Patients with IgA nephropathy in the high v WF level group had a higher risk of renal impairment.3.Plasma v WF level was positively correlated with pathological severity in IgA nephropathy patients,increasing v WF level in plasma will cause more serious pathological characteristics.