Korean J Nephrol.
2006 May;25(3):375-384.
Clinical Study on Prognostic Markers in IgA Nephropathy
- Affiliations
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- 1Department of Internal Medicine, Dong-A University School of Medicine, Busan, Korea. sekim@mail.donga.ac.kr
- 2Department of Pathology, Dong-A University School of Medicine, Busan, Korea.
Abstract
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BACKGROUND: IgA nephropathy is the most common type of glomerulonephritis to progress to the end-stage renal disease. The variable course and long natural history of the disease make it difficult to predict prognosis. The aim of the present study was to search for significant predictive factors at the time of biopsy.
METHODS
Authors investigated the association between prognosis of IgA nephropathy and clinical (age, sex, hypertension, compliance), laboratory (serum creatinine and uric acid, proteinuria, selective proteinuria index, IgA/C3 ratio), and histologic findings at the time of biopsy from 50 patients who were biopsy-proven IgA nephropathy and followed for more than 5 years at our hospital. Two outcomes were analysed. The first, only 46 cases (initial GFR > or =60) were divided into two groups:group 1 (last GFR > or =60 mL/min), group 2 (<60 mL/min). The second, percent change of GFR (from the time of biopsy to 5 yr follow-up GFR) was calculated at each patients and all patients were divided into two groups: group A (GFR-chage <30%), group B(> or =30% and GFR <90 mL/min).
RESULTS
Risk factors for chronic renal failure by multivariate analysis (Cox proportional hazards model) were compliance. And histopathologic classification as Haas has predictive value for rapid deterioration of GFR (p<0.005).
CONCLUSION
Compliance may be predictors for renal survival in the patients with IgA nephropathy by multivariate analysis. Histopathologic classification as Haas was related with rapid reduction of renal function. And hyperuricemia seems to be related with prognosis of IgA nephropathy. But these outcome may need further evaluation by long-term and large cohort study.
