{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:10:14Z","timestamp":1781763014031,"version":"3.54.5"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding"},{"DOI":"10.13039\/100017415","name":"Peking University First Hospital","doi-asserted-by":"publisher","award":["2022CR81"],"award-info":[{"award-number":["2022CR81"]}],"id":[{"id":"10.13039\/100017415","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2019-I2M-5-046"],"award-info":[{"award-number":["2019-I2M-5-046"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070731"],"award-info":[{"award-number":["82070731"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Science Fund for Young Scholars","award":["82100737"],"award-info":[{"award-number":["82100737"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Renal red blood cell casts (RBCC) are common in IgA nephropathy (IgAN), but their role in kidney disease progression of patients with IgAN remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In total, 1425 patients in a Peking University First Hospital IgAN (PKU-IgAN) cohort and 279 patients in the TESTING trial were enrolled to test the association between RBCC and kidney outcome. RBCC was defined as positive (+) when at least one cast was identified within the renal tubules by light microscopy. Kidney endpoint was the composite of the first occurrence of a sustained 30% decrease in estimated glomerular filtration rate or end stage kidney disease or death due to kidney disease. Cox regression analysis was used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In PKU-IgAN, 529 patients (37%) had RBCC; in the TESTING trial, 78 patients (28%) had RBCC. Patients with RBCC had more crescentic lesions, and less segmental sclerosis compared with patients without RBCC. In PKU-IgAN, after a median follow-up of 54 months, 119 patients (22%) with RBCC and 260 patients (29%) without RBCC reached the composite kidney endpoint (P\u00a0=\u00a0.009). In multivariable analysis, RBCC was independently associated with composite kidney endpoint [hazard ratios (HR) 0.79; 95% confidence interval (CI) 0.63\u20130.99; P\u00a0=\u00a0.038]. RBCC and immunosuppressive therapy (IST) had an interaction (P\u00a0=\u00a0.001). RBCC was independently associated with composite kidney endpoint in patients who received IST (HR 0.56; 95%CI 0.40\u20130.77; P\u00a0&amp;lt;\u00a0.001). In the TESTING trial, after a median follow-up of 57 months, 26 patients (33%) with RBCC, and 96 patients (48%) without RBCC reached the composite kidney endpoint (P\u00a0=\u00a0.041). In univariate analysis, RBCC was associated with composite kidney endpoint (HR 0.64; 95%CI 0.42\u20130.99; P\u00a0=\u00a0.047).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Renal RBCC was frequent in IgAN and was associated with a higher incidence of acute active lesions and better renal prognosis, especially in those who received IST, warranting particular attention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfaf023","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T15:21:26Z","timestamp":1738682486000},"page":"1570-1579","source":"Crossref","is-referenced-by-count":4,"title":["Red blood cell casts on kidney biopsy and progression of IgA 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Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Fang","family":"Shi","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Chen","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Jie","family":"Zhou","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Cheng","family":"Lv","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education , Beijing ,","place":["China"]},{"name":"Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Renal Division, Peking University First Hospital, Peking University Institute of Nephrology , Beijing ,","place":["China"]},{"name":"Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of 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