{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:35:22Z","timestamp":1783571722972,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:00:00Z","timestamp":1740182400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470748"],"award-info":[{"award-number":["82470748"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070752"],"award-info":[{"award-number":["82070752"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170737"],"award-info":[{"award-number":["82170737"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370707"],"award-info":[{"award-number":["82370707"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Key Research and Development Project of China","award":["2021YFC2501302"],"award-info":[{"award-number":["2021YFC2501302"]}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"publisher","award":["2022B1515020106"],"award-info":[{"award-number":["2022B1515020106"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"publisher","award":["2023A1515012477"],"award-info":[{"award-number":["2023A1515012477"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Laboratory of National Health Commission, and Key Laboratory of Nephrology, Guangdong Province, Guangzhou, China","award":["2002B60118"],"award-info":[{"award-number":["2002B60118"]}]},{"name":"Key Laboratory of National Health Commission, and Key Laboratory of Nephrology, Guangdong Province, Guangzhou, China","award":["2020B1212060028"],"award-info":[{"award-number":["2020B1212060028"]}]},{"DOI":"10.13039\/501100007162","name":"Guangdong Provincial Department of Science and Technology","doi-asserted-by":"publisher","award":["202201020273"],"award-info":[{"award-number":["202201020273"]}],"id":[{"id":"10.13039\/501100007162","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Guangzhou Municipal Program of Science and Technology","award":["2024B03J1337"],"award-info":[{"award-number":["2024B03J1337"]}]},{"name":"Guangzhou Municipal Program of Science and Technology","award":["202201010166"],"award-info":[{"award-number":["202201010166"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>IgA nephropathy (IgAN) can cause hypertension, and severe hypertension can exacerbate the progression of IgAN. However, the long-term kidney outcome of malignant hypertension (mHTN)-associated thrombotic microangiopathy (TMA) with IgAN is not well defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 292 individuals with mHTN-associated TMA confirmed by kidney biopsy were included. Propensity score matching (PSM) analysis was performed to adjust for clinical characteristics in the comparison between cases with and without IgAN. Cox regression analysis was utilized to identify risk factors associated with long-term kidney outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 86 mHTN-associated TMA with IgAN patients were compared with 206 mHTN-associated TMA with non-IgAN patients. After PSM, 61 pairs of patients with mHTN-associated TMA were matched. The mHTN-associated TMA with IgAN patients exhibited significantly lower serum albumin, higher 24-hour proteinuria, and a higher ratio of global sclerosis than those with non-IgAN. mHTN-associated TMA with IgAN was independently associated with impaired kidney function recovery [hazard ratio (HR), 0.48; 95% confidence interval (CI), 0.24\u20130.96, P\u00a0=\u00a0.038] compared with non-IgAN. This association remained significant after PSM (HR, 0.41; 95% CI, 0.17\u20130.99, P\u00a0=\u00a0.047). In addition, mHTN-associated TMA with IgAN was independently associated with kidney replacement therapy (KRT) compared with non-IgAN (HR, 2.31; 95% CI, 1.38\u20133.88; P\u00a0=\u00a0.002). This difference remained significant after PSM comparison (HR, 2.38; 95%CI, 1.14\u20134.99; P\u00a0=\u00a0.021). In addition, mHTN-associated TMA with IgAN patients had a higher incidence of receiving KRT and a lower incidence of kidney function recovery with a 25% reduction in creatinine levels than in non-IgAN patients, regardless of intensive blood pressure control.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The long-term kidney outcomes for mHTN-associated TMA patients with concomitant IgAN are significantly poorer than that of patients with non-IgAN. Monitoring kidney pathological characteristics will aid management and risk assessment at an early stage.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf017","type":"journal-article","created":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T23:23:51Z","timestamp":1740266631000},"source":"Crossref","is-referenced-by-count":4,"title":["Kidney outcomes of malignant hypertension-associated thrombotic microangiopathy in patients with and without IgA nephropathy: a propensity score-matched analysis"],"prefix":"10.1093","volume":"18","author":[{"given":"Wenchuan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingji","family":"Lian","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou ,","place":["China"]},{"name":"Department of Geriatrics, Guangzhou First People's Hospital, The Second Affiliated Hospital, School of Medicine, South China University of Technology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zefang","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanxin","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7194-8040","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianbo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, NHC Key Laboratory of Clinical Nephrology (Sun Yat-sen University) and Guangdong Provincial Key Laboratory of Nephrology , Guangzhou ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3207-1295","authenticated-orcid":false,"given":"Feng","family":"He","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Guangzhou First People's Hospital, The Second Affiliated Hospital, school of medicine, South China University of Technology , Guangzhou 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