Positive renal familial history in IgA nephropathy is associated with worse renal outcomes: a single-center longitudinal study
Autor: | Naoto Kawata, Fumihiko Koiwa, Tran Thuy Huong Quynh, Tran Nguyen Truc Linh, Yoshinori Sato, Koichiro Higasa, Hiroyasu Tsukaguchi, Ashio Yoshimura, Inoue Yoshihiko, Kiyoko Inui |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Nephrology
medicine.medical_specialty Genetic factor Familial history 030232 urology & nephrology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases Nephropathy End stage renal disease 03 medical and health sciences End-stage renal disease 0302 clinical medicine Internal medicine medicine Humans Genetic Predisposition to Disease Longitudinal Studies Proportional hazards model Surrogate endpoint business.industry Research Glomerulonephritis IGA Odds ratio IgA nephropathy Prognosis medicine.disease Diseases of the genitourinary system. Urology Proteinuria Cohort Disease Progression Kidney Failure Chronic RC870-923 business Glomerular Filtration Rate |
Zdroj: | BMC Nephrology, Vol 22, Iss 1, Pp 1-10 (2021) BMC Nephrology |
ISSN: | 1471-2369 |
Popis: | Background IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Although most IgAN cases are sporadic, few show a familial aggregation. However, the prevalence and prognosis of IgAN individuals with positive familial history (FH) of renal disorders remains uncertain. To address these issues, we conducted a longitudinal observational study on a single-institution cohort of patients with biopsy-proven IgAN. Methods A total of 467 IgAN patients who underwent renal biopsy during 1994 to 2019 were ascertained to have positive- or negative-FH by history taking and were followed for an average of 8.9 years. We compared the clinical and pathological features of the two subgroups. The primary outcome, a composite of a hard endpoint (end-stage renal disease [ESRD]) and surrogate endpoint (a 50% or more reduction in the estimated glomerular filtration rate [eGFR] from baseline), was evaluated. To estimate the risk for progression to ESRD, a Cox proportional hazards analysis was performed for a subset of patients who underwent follow-up for > 2 years and had an eGFR > 30 mL/min/1.73 m2 at baseline (n = 389; observation, 8.7 years). Results Positive-FH subtype accounted for 11.6% (n = 54) of all IgAN patients. At baseline, there were no significant differences between the positive- and negative-FH subgroups regarding age, sex, comorbid disease, MEST-C score, observation period, and therapeutic interventions. However, the eGFR value at baselines was significantly lower in the positive-FH subgroup than in the negative-FH subgroup (P P = 0.03), after adjusting for confounding factors. eGFR at follow-up was significantly lower in the positive-FH subgroup than in the negative-FH subgroup after adjustment for age and observation period. Conclusions Positive-FH was found in 11.6% of all IgAN patients, consistent with the incidence seen in previous literature. A significantly lower eGFR at baseline and last follow-up and unfavorable renal outcomes in the positive-FH subgroup suggest that certain genetic risk factors predisposing to renal failure may exist in a fraction of our IgAN cohort. (331 words). |
Databáze: | OpenAIRE |
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