Clinicopathological characteristics and prognostic factors of asymptomatic IgA nephropathy.

Abstract

AIMS:

Many patients with immunoglobulin class A (IgA) nephropathy (IgAN) present with asymptomatic urinary abnormalities. The purpose of this study was to observe the clinicopathological characteristics and prognostic factors in asymptomatic IgAN.

METHODS:

Eighty-six asymptomatic IgAN patients (49 males and 37 females) were investigated; 82 of them were followed up during a mean +/- SD period of 66.7 +/- 19.7 months.

RESULTS:

At biopsy, 18 patients (21%) presented with pure hematuria (HU), 29 patients (34%) presented with proteinuria alone (PU), and 39 patients (45%) presented concomitant hematuria and proteinuria with severe pathological lesions. Meanwhile, 16% and 26% had renal insufficiency and hypertension, respectively. Finally, urinary abnormalities of 15% of the patients disappeared, 25% of HU developed proteinuria, 47% of concomitant hematuria and proteinuria, and 32% of PU appeared to have increase of proteinuria, and 14% of PU developed hematuria. Fifteen (24%) of the patients with normal blood pressure initially became hypertensive and 18 (22%) of the patients with normal renal function initially developed renal insufficiency. Twenty-four patients (29%) had doubling of serum creatinine level, and 13 patients (16%) progressed to end-stage renal disease. Prednisone therapy and antihypertensive treatment significantly improved proteinuria and renal function deterioration. Hematuria, hypertension during follow-up, and tubulointerstitial lesions were independent risk factors predictive of the ultimate development of renal progression.

CONCLUSIONS:

The renal outcome of asymptomatic IgAN is guarded. Hematuria, hypertension during follow-up, and tubulointerstitial lesions may be important markers to monitor renal progression in the course.

• Authors: Pei-Cheng Shen, Li-Qun He, Ying Tang, Qing Wang, Wei Wang, Jie Li
• Journal: Journal of investigative medicine : the official publication of the American Federation for Clinical Research (J Investig Med) Vol. 58 Issue 3 Pg. 560-5 (Mar 2010) ISSN: 1708-8267 [Electronic] England
• PMID: 20215916 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Prednisone

Topics

• Adult
• Biopsy
• Female
• Follow-Up Studies
• Glomerulonephritis, IGA (diagnosis, drug therapy, pathology)
• Humans
• Male
• Prednisone (therapeutic use)
• Prognosis
• Risk Factors
• Treatment Outcome