IgA nephropathy natural history, complications and prognosis
IgA nephropathy Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
IgA nephropathy natural history, complications and prognosis On the Web |
American Roentgen Ray Society Images of IgA nephropathy natural history, complications and prognosis |
FDA on IgA nephropathy natural history, complications and prognosis |
CDC on IgA nephropathy natural history, complications and prognosis |
IgA nephropathy natural history, complications and prognosis in the news |
Blogs on IgA nephropathy natural history, complications and prognosis |
Risk calculators and risk factors for IgA nephropathy natural history, complications and prognosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History
The clinical course of IgA nephropathy varies widely between patients. Although it is generally regarded as a benign disease, emerging data has shown that progression to ESRD and death are more common than originally believed.[1] Some patients rapidly progress into ESRD; but the majority experience a stable kidney function following diagnosis.[1] Commonly, the progression of IgA nephropathy is slower than other notorious glomerular disease. Approximately 20-30% of patients with IgA nephropathy progress to ESRD after 10 years[1] and up to 30-50% of patients develop ESRD over 20 years.[2][3]
Complications
Prognosis
Male gender, proteinuria (especially > 2 g/day), hypertension, smoking, hyperlipidemia, older age, familial disease and elevated creatinine concentrations are markers of a poor outcome. Frank hematuria has shown discordant results with most studies showing a better prognosis, perhaps related to the early diagnosis, except for one group which reported a poorer prognosis. Proteinuria and hypertension are the most powerful prognostic factors in this group[2]. There are certain other features on kidney biopsy such as interstitial scarring which are associated with a poor prognosis. ACE gene polymorphism has been recently shown to have an impact with the DD genotype associated more commonly with progression to renal failure.
References
- ↑ 1.0 1.1 1.2 Haubitz M, Wittke S, Weissinger EM, Walden M, Rupprecht HD, Floege J; et al. (2005). "Urine protein patterns can serve as diagnostic tools in patients with IgA nephropathy". Kidney Int. 67 (6): 2313–20. doi:10.1111/j.1523-1755.2005.00335.x. PMID 15882273.
- ↑ Velo M, Lozano L, Egido J, Gutierrez-Millet V, Hernando L (1987). "Natural history of IgA nephropathy in patients followed-up for more than ten years in Spain". Semin Nephrol. 7 (4): 346–50. PMID 3445013.
- ↑ Radford MG, Donadio JV, Bergstralh EJ, Grande JP (1997). "Predicting renal outcome in IgA nephropathy". J Am Soc Nephrol. 8 (2): 199–207. PMID 9048338.