The Expression And Significance Of VEGF, ET-1 In Renal Vascular Lesions With IgA Nephropathy

Background and ObjectiveIgA nephropathy (IgAN) is one of the most common primary glomerular diseases.and one of the important causes that lead to end-stage renal disease in china. It is an entity with diffenent causes and clinical menifestations,but the same immunopathological characteristics. The progression of IgAN is not only closely related with glomerular changes but also the lesions of kidney vessels which predicts the poor outcome. Vascular endothelial growth factor (VEGF) is a highly specific factor that promotes cleavage of endothelial cells and a powerful vascular permeability factor (VPF).Its binding with the receptor may be involved in the kidney lesions that caused by metabolic disease,vascular disease and systemic disease. But it is still not known whether VEGF participates in the progression IgA nephropathy. Endothelin-1 (ET-1) is the strongest vasoconstrictive peptide which could alter the kidney hemodynamic,Participates in the inflammatory response and remodeling of the renal vascular lesions,and as a result plays an important role in the process of vascular lesions in IgAN. In our study,we detected the expression of VEGF, ET-1 in kidney vessels through immunohistochemical staining, and in order to explore their roles in the disease progression of IgA nephropathy.Methods Pathological and clinical datas of 100 IgA nephropathy cases and 48 minimal change disease(MCD) cases were collected in our hospital. IgAN cases were divided into 2 groups:IgAN with vascular disease(group A) and IgAN without vascular disease(group B), with MCD as the control group (group C). VEGF and ET-1 expression was detected through the immunohistochemical staining and their correlations with clinical indexes were analysed.Results1. The expression of VEGF and ET-1 in group IgAN with vascular disease was higher than that in group IgAN without vascular disease and the control group, accounting for 94.23% and 98.08%, were statistically significant (P<0.01).2. The expression of VEGF and ET-1 was positively correlated with systolic blood pressure, diastolic blood pressure, serum creatinine and serum uric acid level, but negatively correlated with 24-hour urine protein the comparison between groups were statistically significant(P<0.05).3. There were no significant difference between the three groups as to age and gender (P>0.05);The difference of systolic blood pressure, diastolic blood pressure,24-hour urine protein, serum albumin, creatinine and uric acid level between the three groups were were statistically significant (P<0.05); The incidence of hypertension and microscopic hematuria in group A was significantly higher than that in group B and C(P<0.01).Conclusions1. The expression of VEGF and ET-1 was significantly higher in IgAN with vascular disease, suggesting that both play important role in the IgAN vascular disease.2. The expression of VEGF and ET-1 were positively correlated with blood pressure, serum creatinine, and serum uric acid,which indicates both of them are promising predictive factors and intervenetional target.