Serum GDF15 Could Predict Cardiorenal Prognosis in Patients with IgA Nephropathy

Background: To investigate the correlation between serum GDF15 and the clinical and pathological characteristics of patients with immunoglobulin A nephropathy (IgAN) and further explore its relationship with the cardiac and renal prognosis of IgAN patients. Methods: This study enrolled 104 patients who were diagnosed with primary IgAN at our center from January 2018 to December 2022 and were regularly followed up for at least one year. Serum GDF15 was measured, and the correlation between serum GDF15 and the clinical and pathological characteristics of patients with IgAN at the time of renal biopsy was analyzed. Furthermore, the relationship was analyzed between the serum GDF15 and the cardiac and renal prognosis of patients with IgAN. Results: We found that serum GDF15 levels were positively correlated with 24h urinary protein quantification (r=0.405, P<0.001), negatively correlated with eGFR (r= -0.606, P<0.001), and were higher in patients correlated with tubular atrophy or interstitial fibrosis, crescent-shaped lesions, and intrarenal arteriolar lesions. The median GDF15 825.60 pg/ml was used as the cut-off value to divide IgAN patients into a high-level GDF15 group (Group High, n= 52) and a low-level GDF15 group (Group Low, n=52). Compared to Group Low, IgAN patients in Group High presented with had a higher proportion of diabetes mellitus (P=0.002) and basic cardiovascular disease (P=0.005), had higher levels of systolic blood pressure (P=0.019023), BMI (P=0.031), initial urinary proteins (P<0.001), blood creatinine (P<0.001), blood total cholesterol (P=0.045), complement C4 (P=0.008), and left ventricular mass index (P=0.008), while having lower levels of blood albumin (P=0.002) and eGFR (P<0.001). Moreover, the cardiac and renal prognosis was significantly worse in patients of Group High (P=0.002). Conclusion: High serum GDF15 levels correlated with disease severity in IgAN, and high serum GDF15 levels may suggest a poorer cardiorenal prognosis in IgAN patients.