Long-term Prognosis of IgA Nephroapthy / 대한신장학회잡지

BACKGROUND: IgA nephropathy (IgAN) is the most frequent primary glomerulonephritis in the world. Despite 20 years of research into this condition, much remains unknown about its pathogenesis and therapy. One major problem is that the prognostic evaluation and renal survival of IgAN is unreliable. METHODS: A retrospective study was performed to clarify the prognostic factors and the long-term renal survival rates of this disease. RESULTS: One hundred fifty-two patients with IgAN who followed-up at least 3 years after renal biopsy were included in this study. During a mean followed-up of 9.3 years after their renal biopsy (range:36-215 months), 33 of them (21.7%) had progressed to end-stage renal disease (ESRD). The actuarial renal survival rate was 97% at 5 years, and 85% at 10 years. Using univariate analysis, 5 risk factors for developing ESRD were identified:male sex, hypertension, heavy proteinuria, renal insufficiency at the time of biopsy, severe histopathologic findings such as subclass IV/V lesions by Haas' subclassification were associated with significant risk factors for developing ESRD. In multivariate regression analysis, only Haas' subclass IV/V lesions and renal insufficiency at the time of biopsy were the independent prognostic factors of IgAN. CONCLUSION: In conclusion, further long-term prospective study with larger number of patients would be necessary to assess the prognostic factors in IgAN.

A case of secondary renal amyloidosis complicating Crohn's disease / 대한내과학회지

Secondary amyloidosis is characterized by accumulation of an amorphous proteineous material in the various tissue and orgrans with infectious or inflammatory disease. Renal amyloidosis in Crohn's disease is a rare condition with proteinuria in the most cases and serious clinical complication due to the unfavorable prognosis. We are reporting a case of secondary renal amyloidosis in a 30-year old man with Crohn's disease presenting with nephrotic syndrome and renal failue.