The aim of the present study was to examine the effects of epithelial-mesenchymal transition (EMT) and apoptosis of renal tubular epithelial cells on the prognosis of
immunoglobulin A (
IgA) nephropathy. Renal biopsy tissues from 74 cases of
IgA nephropathy were divided into a mild mesangial proliferation group (27 cases), a focal
hyperplasia group (28 cases) and a proliferative
sclerosis group (19 cases). The blood pressure, serum
creatinine and 24 h urinary
protein excretion of all patients were detected. To define EMT, α-smooth muscle actin (α-SMA),
vimentin and
collagen fibers were assessed. Apoptosis was determined by
terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). The blood pressure, serum
creatinine and 24 h urinary
protein excretion of patients with
IgA nephropathy altered with increasing pathological grade. All clinical indices of patients in the proliferative
sclerosis group were higher than those of the other two groups, and the 24 h urinary
protein excretion of the focal
hyperplasia group was statistically higher than that of the mild mesangial proliferation group. The expression of tubular interstitial α-SMA,
vimentin and
collagen fibers increased with the pathological grade and was closely correlated with clinical indices, including
collagen fibers and 24 h urinary
protein excretion. TUNEL-positive cells increased with the exacerbation of pathological changes. The EMT and apoptosis of renal tubular epithelial cells reflected the clinical severity of
IgA nephropathy. α-SMA,
vimentin and the apoptotic index may be used as important markers for evaluating the prognosis of
IgA nephropathy.