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Purpose <p>There are few reports of renal involvement in Common Variable Immunodeficiencies (CVID) and, when present, is due to infections, inflammation, or treatments. The aim of this study was evaluating the prevalence of chronic kidney disease (CKD) and to identify CVID-related clinical, laboratory and therapeutic features inducing it.</p> Methods <p>A multicenter observational retrospective study on 367 adult CVID patients from five Italian Referral Centers for Primary Immunodeficiency.</p> Results <p>CKD was identified in 23 (6.27%) patients that were older (<i>p</i> &lt; 0.001), had arterial hypertension (<i>p</i> &lt; 0.001), diabetes (<i>p</i> = 0.002), dyslipidemia (<i>p</i> = 0.002), presented different ultrasound abnormalities (<i>p</i> &lt; 0.001) and received predominantly intravenous immunoglobulins (IVIG) (<i>p</i> = 0.016). Regarding CVID infectious and non-infectious manifestations, CKD patients presented a higher frequency of COPD (<i>p</i> = 0.008). In the CKD group, the median absolute count of total lymphocytes (<i>p</i> = 0.015), the percentage of total B (<i>p</i> = 0.028) and transitional B cells (<i>p</i> = 0.008) were lower. By binomial logistic regression analysis adjusted for age, CKD patients tend to develop autoimmune cytopenia, had lower B cells percentage, increased Neutrophil-to-lymphocyte ratio and received more frequently trimethoprim-sulfamethoxazole antibiotic prophylaxis. By multivariate analysis, only autoimmune cytopenia was independently associated with CKD.</p> Conclusion <p>The prevalence of CKD in CVID is due to aging, age-related comorbidities, disease-related immune dysregulation and inflammation. Our results suggest evaluating renal function in all CVID patients, and mostly in those with a higher “inflammatory” burden.</p>

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Chronic Kidney Disease in Common Variable Immunodeficiency: a Multicenter Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月23日

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  • Chiara De Renzis,
  • Renato Finco Gambier,
  • Antonietta Gigante,
  • Carla Maria Deiana,
  • Gianluca Lagnese,
  • Lorenzo Gatti,
  • Giulia Garzi,
  • Giulia Costanzo,
  • Chiara Pagnozzi,
  • Stefania Nicola,
  • Luisa Brussino,
  • Giuseppe Spadaro,
  • Marcello Rattazzi,
  • Davide Firinu,
  • Francesco Cinetto,
  • Cinzia Milito

摘要

Purpose

There are few reports of renal involvement in Common Variable Immunodeficiencies (CVID) and, when present, is due to infections, inflammation, or treatments. The aim of this study was evaluating the prevalence of chronic kidney disease (CKD) and to identify CVID-related clinical, laboratory and therapeutic features inducing it.

Methods

A multicenter observational retrospective study on 367 adult CVID patients from five Italian Referral Centers for Primary Immunodeficiency.

Results

CKD was identified in 23 (6.27%) patients that were older (p < 0.001), had arterial hypertension (p < 0.001), diabetes (p = 0.002), dyslipidemia (p = 0.002), presented different ultrasound abnormalities (p < 0.001) and received predominantly intravenous immunoglobulins (IVIG) (p = 0.016). Regarding CVID infectious and non-infectious manifestations, CKD patients presented a higher frequency of COPD (p = 0.008). In the CKD group, the median absolute count of total lymphocytes (p = 0.015), the percentage of total B (p = 0.028) and transitional B cells (p = 0.008) were lower. By binomial logistic regression analysis adjusted for age, CKD patients tend to develop autoimmune cytopenia, had lower B cells percentage, increased Neutrophil-to-lymphocyte ratio and received more frequently trimethoprim-sulfamethoxazole antibiotic prophylaxis. By multivariate analysis, only autoimmune cytopenia was independently associated with CKD.

Conclusion

The prevalence of CKD in CVID is due to aging, age-related comorbidities, disease-related immune dysregulation and inflammation. Our results suggest evaluating renal function in all CVID patients, and mostly in those with a higher “inflammatory” burden.