[A familial history of hypertension is associated with the development of hypertension and nephroangiosclerosis in patients with glomerulonephritis caused by mesangial IgA deposits]. / Une histoire familiale d'hypertension artérielle est associée à la survenue d'une hypertension artérielle et d'une néphro-angiosclérose chez les patients atteints de glomérulonéphrite à dépôts mésangiaux d'IgA.

The progress of IgA Nephropathy (IgAN) is correlated with glomerular and vascular sclerosis. Renal vascular lesions, i.e. nephrosclerosis, often precede the onset of hypertension (HBP) in young patients with IgAN. It is also recognized that a family history of HBP (FHBP) is strongly predictive of future onset of HBP in family members, when two or more first-degree relatives with HBP are identified. In order to examine the possible link between FHBP and nephrosclerosis, we compared 2 groups of 29 pts each (23 M and 6 F) with IgAN, matched for age and sex, according to the presence or absence of FHBP. FHBP was considered present if at least 2 or more 1st degree relatives under 60 years of age received antihypertensive Rx. Parents and siblings of patients were examined at home by two investigators. Patients with FHBP (+) and FHBP (-) were aged 36 +/- 12 and 35 +/- 12, respectively, at the time of renal biopsy and the follow-up was conducted for an average of 4.6 years. At the end of this survey, HBP and renal failure (Cr Cl < 80 ml/min) were reevaluated in all patients. At the time of renal biopsy, nephrosclerosis was significantly associated with FHBP: FHBP (+): 96.5% versus FHBP(-): 10.3%; p < 0.0001. At the end of the follow-up, FHBP was found to be associated with HBP (89.6% versus 10.3%; p < 0.001) and with renal failure (44.8% versus 3.4%; p < 0.001). These data suggest that nephrosclerosis has a strong genetic component in patients with IgAN, FHBP is an early clinical indicator of nephrosclerosis in these patients and that FHBP is a strong indicator of unfavorable prognosis in IgAN.

[Epidemiology of primary glomerulopathies in a French region. Variations as a function of age in patients]. / Epidémiologie des glomérulopathies primitives dans une région française. Variations en fonction des périodes et de l'âge des sujets.

Between January 1st, 1976 and December 31st, 1990, histological diagnosis of primary glomerular diseases (PGD) was made in 480 patients born and living at the time of diagnosis in a region of France comprising 410,664 inhabitants, of whom 390,574 were aged from 10 to 80 years. The prevalence of PGD during a 70-year exposure to risk (10-80 years of age) was evaluated to 5.7 in 1000 (7.6 in 1000 males and 3,8 in 1000 females). The most common PGD was IgA nephropathy with a prevalence of 1.9 in 1000 (3.3 in 1000 males, 1 in 1000 females). The annual incidence of the disease was evaluated separately for 3 consecutive 5-year periods: period A (1976-80), period B (1981-85), and period C (1986-90). Within each of these 3 periods the number of patients with PGD was 179, 170 and 131 respectively, and annual incidence was 9.3, 8.8 and 6.7 in 100,000. The incidence of IgA nephropathy remained the same throughout the 3 periods: 2.6, 3.1 and 2.5 in 100,000. The incidence of membranoproliferative glomerulonephritis decreased from 1981 onward (0.9, 0.5 and 0.15/100,000). Acute streptococcal glomerulonephritis virtually disappeared during periods B and C. Lipoid nephrosis was less frequent in period C and idiopathic proliferative glomerulonephritis with crescents slightly increased (0.3, 0.3 and 0.6 in 100,000). There was no significant difference between the 3 periods regarding the incidence of other PGD. Incidence of IgA nephropathy was 3 to 4-fold higher in the adult aged from 20 to 60 years than in the elderly. In contrast, membranous nephropathy was 3 fold more frequent in the elderly than in the adult. Therefore only some histopathological forms have a different incidence according to age, but the major information furnished by this study is that the risk of occurrence of a PGD is similar in the population living in the area, whatever the age group (10-19 years: 6.4/10(5) inhabitants, 20-39: 7.1/10(5), 40-59: 8.4/10(5), 60-79: 8.4/10(5)). Finally, we confirm that the most common PGD going to end stage renal disease was IgA nephropathy, particularly under 60 years of age (0.8/10(5)). In contrast, membranous nephropathy was a less frequent cause of ESRD (0.2/10(5)).

Epidemiology of primary glomerular diseases in a French region. Variations according to period and age.

Between January 1, 1976 and December 31, 1990, histological diagnosis of primary glomerular diseases (PGD) was made in 480 patients born and living at the time of diagnosis in a region of France, comprising 410,664 inhabitants, of whom 390,574 were aged from 10 to 80 years. The prevalence of PGD during a 70 year exposure to risk (10 to 80 years of age) was evaluated to 5.7 in 1000 (7.6 in 1000 males and 3.8 in 1000 females). The most common PGD was IgA nephropathy with a prevalence of 1.9 in 1000 (3.3 in 1000 males, 1 in 1000 females). The annual incidence of the disease was evaluated separately for three consecutive five-year periods: period A (1976-80), period B (1981-85), and period C (1986-90). Within each of these three periods the number of patients with PGD was 179, 170 and 131, respectively, and annual incidence was 9.3, 8.8 and 6.7 in 100,000. The incidence of IgA nephropathy remained the same throughout the three periods: 2.6, 3.1 and 2.5 in 100,000. The incidence of membranoproliferative glomerulonephritis decreased from 1981 onward (0.9, 0.5 and 0.15 in 100,000), while that of membranous nephropathy increased slightly (1.2, 1.6 and 1.7 in 100,000). Acute streptococcal glomerulonephritis virtually disappeared during periods B and C. Lipoid nephrosis was less frequent in period C and idiopathic proliferative glomerulonephritis with crescents slightly increased (0.3, 0.4 and 0.6 in 100,000). There was no significant difference between the three periods regarding the incidence of other PGD.(ABSTRACT TRUNCATED AT 250 WORDS)