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Long-term prognosis of clinically early lgA nephropathy is not always favorable : Long-term prognosis of clinically early IgA nephropathy is not always favorable

Cited 35 time in Web of Science Cited 38 time in Scopus
Authors

Lee, Hajeong; Hwang, Jin Ho; Paik, Jin Ho; Ryu, Hyun Jin; Kim, Dong Ki; Chin, Ho Jun; Oh, Yun Kyu; Joo, Kwon Wook; Lim, Chun Soo; Kim, Yon Su; Lee, Jung Pyo

Issue Date
2014-06
Publisher
BioMed Central
Citation
BMC Nephrology, Vol.15 No.1, p. 94
Abstract
Background: The long-term prognosis of clinically early lgA nephropathy (lgAN) patients remains to be clarified. We investigated the long-term outcomes of lgAN patients with an apparently benign presentation and evaluated prognostic factors for renal survival. Methods: We included patients with biopsy-proven lgAN who had estimated glomerular filtration rates (eGFR) >= 60 mL/min/1.73 m(2), normal blood pressure, and proteinuria <0.5 g/day at the time of biopsy. The primary outcome was progression to end-stage renal disease (ESRD). The secondary outcome was a 50% increase in serum creatinine level or an increase in proteinuria to >1 g/day. Results: The analysis included 153 patients who met the inclusion criteria. At diagnosis, their median systolic blood pressure was 120 (110-130) mmHg, eGFR was 85.9 (74.9-100.1) mL/min/1.73 m(2), and proteinuria was 0.25 (0.13-0.38) g/day. Of these, 4 patients died and 6 reached ESRD. The 30-year renal survival rate was 85.5%. Three patients had increased serum creatinine levels and 11 developed proteinuria. Remission was observed in 35 (22.9%) patients. A moderate or severe degree of interstitial fibrosis (adjusted odd ratio [OR] 5.93, 95% confidence interval [CI] 1.44-24.45, P = 0.014) and hypoalbuminemia (adjusted OR 6.18, 95% CI 1.20- 31.79, P = 0.029) were independent predictors of the secondary outcome. Conclusions: This study showed that the prognosis of early lgAN was not always favorable, even resulting in progression to ESRD in some cases. Hypoalbuminemia and interstitial fibrosis should also be considered important prognostic factors in clinically early lgAN patients.
ISSN
1471-2369
URI
https://hdl.handle.net/10371/192030
DOI
https://doi.org/10.1186/1471-2369-15-94
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Paik, Jin Ho백진호
(기금)부교수
  • College of Medicine
  • Department of Medicine
Research Area Head and Neck Pathology, Hematopathology, Renal Pathology, 두경부병리학, 신장병리학, 혈액병리학

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