Correlation Between Initial Urine V-ATPase and Pathological Changes in IgA Nephropathy: Implications for Short-Term Outcomes

This study aimed to investigate the alterations in expression and clinical relevance of ATP6V1A and ATP6V1E1 in urine samples from patients with IgA nephropathy(IgAN). The research included a cohort of 55 patients diagnosed with IgAN and a control group of 30 healthy individuals, with no significant differences in age or gender between the groups. The maximum tolerated dose of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor antagonists(ARB) was used for 6 months. Treatment effectiveness was defined as a reduction in urinary protein of more than 50% from baseline. The results demonstrated that the urinary expression levels of ATP6V1A and ATP6V1E1 in patients with IgAN were significantly lower than those observed in the healthy control group. And in IgAN group, the expression of ATP6V1A in urine was significantly lower in patients with Tubular atrophy and interstitial fibrosis. Patients with IgAN were divided into low expression group and high expression group according to the median urinary levels of ATP6V1A and ATP6V1E1, and there was no significant difference in baseline proteinuria between the two groups. ATP6V1A Low-expression groups showed significantly higher proteinuria levels after 6 months of treatment compared to high-expression groups, as well as notably lower treatment efficacy. However, the two ATP6V1E1 groups did not differ significantly in either proteinuria levels or treatment efficacy at 6 months. Accordingly, urinary ATP6V1A may be a useful biomarker for detecting disease severity and therapeutic response in patients with IgAN.