{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:22:56Z","timestamp":1783527776856,"version":"3.55.0"},"reference-count":46,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kidney Dis"],"abstract":"<jats:p>Introduction: Interstitial fibrosis and tubular atrophy (IFTA) are common pathological findings in patients with malignant hypertension (mHTN)-related thrombotic microangiopathy (TMA), but their predictive value for renal outcomes in this population remains unclear. Methods: This study included patients with mHTN-related TMA confirmed by renal biopsy, admitted to seven different Chinese hospitals from January 2008 to October 2024. Patients were stratified into mild\/moderate, severe, and extremely severe IFTA groups based on renal biopsy findings. The primary outcome was renal replacement therapy (RRT) dependence during follow-up, while the secondary outcome was renal function recovery. Results: A total of 465 patients (median age: 35 years, 87.74% male) were included in this study. During a median follow-up of 24 months, RRT dependence occurred in 182 patients and renal function recovery occurred in 226 patients. Kaplan-Meier analysis showed higher RRT risk with more severe IFTA. Cox regression models showed that severe and extremely severe IFTA groups had hazard ratios of 2.29 (95% CI: 1.59\u20133.28) and 8.00 (95% CI: 5.36\u201311.95) for RRT dependence compared to mild\/moderate IFTA group (both p &lt; 0.05), even after adjusting for clinical variables and the proportion of global glomerulosclerosis. The cumulative probability of renal function recovery also differed among IFTA groups (log-rank p &lt; 0.001). Extremely severe IFTA negatively impacted renal function recovery in unadjusted analysis, but this significance disappeared after adjusting for the proportion of global glomerulosclerosis. Conclusion: IFTA may serve as a valuable and independent predictor of renal outcomes in patients with mHTN-related TMA, highlighting its importance for clinical decision-making.<\/jats:p>","DOI":"10.1159\/000552331","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:01:30Z","timestamp":1777910490000},"page":"527-538","source":"Crossref","is-referenced-by-count":0,"title":["Interstitial Fibrosis and Tubular Atrophy as a Predictor of Renal Outcomes in Patients with Malignant Hypertension-Related Thrombotic Microangiopathy: A Multicentric Cohort 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