Prognostic factors in immunoglobulin-A nephropathy.
Article
in English
| IMSEAR
| ID: sea-92693
ABSTRACT
AIM:
To study the course, identify prognostic factors and a model predictive for development of end stage renal failure (ESRF) in adults with immunoglobulin-A nephropathy (IgA-N).DESIGN:
Retrospective cohort.SETTING:
Madras Medical College and Government General Hospital, Chennai, Tamil Nadu.PARTICIPANTS:
Ninety eight adult patients with diagnosis of primary IgA nephropathy.RESULTS:
Out of 98 patient 64 (65.3%) were men. Mean age of presentation was 25.7 years. The predominant renal lesions included nephrotic syndrome in 25 (25.5%), rapidly progressive renal failure and accelerated malignant hypertension in 21 (21.4%) each, chronic renal failure in 13 (13.3%), hypertension in nine (9.2%) haematuria in five (5.1%) and acute renal failure in four (4.1%). Sixty (61%) had renal failure at diagnosis. Age > 25 years, glomerular histology of Hass subclass V and interstitial fibrosis were significant factors. Forty (48.2%) (IR) patients developed ESRF during follow up. Serum creatinine > 5 mg/dl (hazard ratio 5.37, 95% confidence interval CI 2.49-11.58) Hass-V (3.74, 1.60-8.76), crescents (4.08, 1.52-10.94) and IF (6.15, 2.0-19.0) were associated with disease progression in the multivariate analysis. Five years renal survival (CI) was 38.5% (24.6%-52.3%). Among those with no risk factor, 95% had not reached ESRF by 42 months. The median ESRF-free survival with one, two and three or four risk factors was 65, 16 and four months, respectively.CONCLUSIONS:
Serum creatinine > 5 mg/dl, crescents Hass-V histology and interstitial fibrosis predict the progression to ESRF. Renal biopsies should include a detailed assessment of the tubulointerstitium.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Prognosis
/
Proteinuria
/
Female
/
Humans
/
Male
/
Survival Analysis
/
Multivariate Analysis
/
Retrospective Studies
/
Risk Factors
/
Adolescent
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Year:
2002
Type:
Article
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