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Paper Information

Journal:   IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD)   DECEMBER 2009 , Volume 3 , Number SUPPLEMENT 1 (12TH INTERNATIONAL CONGRESS OF NEPHROLOGY, DIALYSIS, AND TRANSPLANTATION); Page(s) 63 To 63.
 
Paper: 

CLINICAL AND PATHOLOGICAL PROGNOSTIC INDICATORS OF IGA NEPHROPATHY IN IRANIAN PATIENTS (ORAL PRESENTATIONS: O501)

 
 
Author(s):  SOLEYMANIAN T., NAJAFI I., HAJI SALIMI B., BROUMAND B., GANJI M.R., HAKEMI M., SADADI F.
 
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Abstract: 

Introduction. Immunoglobulin A (IgA) nephropathy is the most common cause of primary glomerulonephritis with slow progression to end-stage renal disease (ESRD) in up to 40% of the patients.
Methods. A retrospective cohort study of patients with biopsy proven IgA nephropathy was performed in our center from 1997 to 2008. We tried to determine the clinical and pathological data that was associated with the prognosis of the disease. Clinical characteristics at the time of renal biopsy and follow-up were reviewed. Severity of histology was quantified as grade 1 to 3. Results. There were 70 IgA nephropathy patients and 46 were men. The average age of the patients at biopsy time was 39
± 12.1 years. During the median 23.5 (range, 6 to 130 months) months of follow-up, 10 patients progressed to ESRD and no patient died. Median time of progression to ESRD was 107 (range, 62 to 152 months) months. The renal survival was 94% at one year, 91% at 3 years, and 88% at 5 years. A higher histological grade of IgA nephropathy was associated with higher baseline age (P = 0.003), higher mean arterial pressure (P = 0.01), greater serum creatinine (P <0.001), more 24-hour urine protein excretion (P = 0.002), and higher number of ESRD events (P <0.001). Odds ratio of ESRD events for patients older than 50 years was 13.5 (CI: 95% 2.9-61.7, P = 0.001), increase of serum creatinine (mg/dl) was 3.7 in each group (1.6-8.6, P = 0.003) and for daily proteinuria more than 3 g/24h was 13.1(2.5-69.2, P = 0.002). We had no ESRD event in patients with grade I pathology, and odds ratio for grade III versus II was 12 (2.2-64.5, P = 0.004). ESRD events were also more common in male and hypertensive patients but not at significant level.
Conclusion. Although the number of studied patients and median time of follow-up in our study is limited, we showed that kidney biopsy and risk stratification of different factors at baseline in IgA nephropathy are useful for predicting the prognosis and probably appropriate intervention.

 
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