Clinicopathological Characteristics and Prognostic Factors of Asymptomatic IgA Nephropathy
| Autor: | Jie Li, Þ Ying Tang, Qing Wang, Pei-Cheng Shen, Wei Wang, Þ Li-Qun He |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Biopsy Urinary system Renal function urologic and male genital diseases Gastroenterology Asymptomatic General Biochemistry Genetics and Molecular Biology Nephropathy Risk Factors Prednisone Internal medicine medicine Humans Proteinuria business.industry Glomerulonephritis IGA Glomerulonephritis General Medicine Prognosis medicine.disease female genital diseases and pregnancy complications Treatment Outcome Concomitant Female medicine.symptom business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of Investigative Medicine. 58:560-565 |
| ISSN: | 1708-8267 1081-5589 |
| DOI: | 10.2310/jim.0b013e3181d20aa1 |
| Popis: | Aims Many patients with immunoglobulin class A (IgA) nephropathy (IgAN) present with asymptomatic urinary abnormalities. The purpose of this study was to observe the clinicopathological characteristics and prognostic factors in asymptomatic IgAN. Methods Eighty-six asymptomatic IgAN patients (49 males and 37 females) were investigated; 82 of them were followed up during a mean ± SD period of 66.7 ± 19.7 months. Results At biopsy, 18 patients (21%) presented with pure hematuria (HU), 29 patients (34%) presented with proteinuria alone (PU), and 39 patients (45%) presented concomitant hematuria and proteinuria with severe pathological lesions. Meanwhile, 16% and 26% had renal insufficiency and hypertension, respectively. Finally, urinary abnormalities of 15% of the patients disappeared, 25% of HU developed proteinuria, 47% of concomitant hematuria and proteinuria, and 32% of PU appeared to have increase of proteinuria, and 14% of PU developed hematuria. Fifteen (24%) of the patients with normal blood pressure initially became hypertensive and 18 (22%) of the patients with normal renal function initially developed renal insufficiency. Twenty-four patients (29%) had doubling of serum creatinine level, and 13 patients (16%) progressed to end-stage renal disease. Prednisone therapy and antihypertensive treatment significantly improved proteinuria and renal function deterioration. Hematuria, hypertension during follow-up, and tubulointerstitial lesions were independent risk factors predictive of the ultimate development of renal progression. Conclusions The renal outcome of asymptomatic IgAN is guarded. Hematuria, hypertension during follow-up, and tubulointerstitial lesions may be important markers to monitor renal progression in the course. |
| Databáze: | OpenAIRE |
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