Presentation, prognosis and outcome of IgA nephropathy in Indian adults
- 13 October 2005
- journal article
- Published by Wiley in Nephrology
- Vol. 10 (5), 496-503
- https://doi.org/10.1111/j.1440-1797.2005.00445.x
Abstract
Background: IgA nephropathy (IgAN) is not well characterized in India. This retrospective study of 478 patients with IgAN was performed to clarify the presenting features, prognostic factors and the renal survival rates of the disease. Methods: Three hundred and forty-seven patients who had been followed on average for 27 months after diagnosis were divided into two groups based on renal function at diagnosis. In group 1 (229 patients), the creatinine clearance estimated by the Modification of Diet in Renal Disease formula was <85 mL/min and in group 2 (118 patients) it was ≥85 mL/min. Results: The predominant modes of presentation were nephrotic syndrome, hypertension and renal failure. Twenty-nine percent of patients had more than a 20% decline in renal function at the last follow up. Multivariate analyses with stepwise logistic regression identified hypertension (odds ratio (OR) 3.5), nephrotic range proteinuria (OR 3.4) and sclerosed glomeruli on biopsy (OR 4.1) to be independently associated with progression in group 1 and hypertension (OR 2.3) in group 2. Seventeen percent of patients progressed to end-stage renal disease (ESRD). Using multivariate analysis by the Cox model, four risk factors for developing ESRD were identified: hypertension (hazard ratio (HR) 3.1); nephrotic proteinuria (HR 1.9); interstitial fibrosis (HR 2.5); and sclerosed glomeruli (HR 1.8). The renal survival rates at 1, 5 and 10 years were 84, 55 and 33%, respectively, with a median renal survival of 61 months from the time of biopsy. Conclusion: The relatively rapid rate of progression of IgAN in India is suggestive towards a ‘malignant’ nature of the disease in this country.Keywords
This publication has 12 references indexed in Scilit:
- Factors associated with progression of IgA nephropathy are related to renal function – A model for estimating risk of progression in mild diseaseClinical Nephrology, 2002
- Goodpasture syndrome during the course of a Schönlein-Henoch purpuraAmerican Journal of Kidney Diseases, 2002
- Hypertriglyceridaemia and hyperuricaemia are risk factors for progression of IgA nephropathyNephrology Dialysis Transplantation, 2000
- Association of angiotensinogen gene T235 variant with progression of immunoglobin A nephropathy in Caucasian patients.JCI Insight, 1997
- Polymorphisms in angiotensin-converting-enzyme gene and progression of IgA nephropathyThe Lancet, 1995
- Prognostic Factors in Mesangial IgA Glomerulonephritis: An Extensive Study With Univariate and Multivariate AnalysesAmerican Journal of Kidney Diseases, 1991
- Toward individual prognosis of IgA nephropathyKidney International, 1986
- Idiopathic IgA Mesangial NephropathyMedicine, 1985
- Mesangial IgA NephropathyAmerican Journal of Kidney Diseases, 1983
- IgA nephropathy: Morphologic predictors of progressive renal diseaseHuman Pathology, 1982