Severity of Glomerulosclerosis Predicts Prognosis of IgA Nephropathy with Proteinuria

概要

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We determined the natural history of IgA nephropathy (IgAN) among patients who presented with proteinuria, and factors associated with the development of clinical events, namely blood pressure(BP)竕ｧ130/85 mmHg, serum creatinine 竕ｧ1.4mg/dl. We analyzed data from 16 patients(mean age 35 ﾂｱ 14 years) with IgAN accompanied by proteinuria between 1990 and 1998. We also semiquantified scores of glomerulosclerosis (GS), tubulointerstitial damage (TID), hyaline arteriosclerosis (HA), and IgAN classification. The median duration of follow-up was 48 months. During clinical follow-up, seven (44%) patients became hypertensive, among who five (31%) developed impaired renal function and two (13%) progressed to treatment with hemodialysis. Events did not develop in the other 9 patients (56%). Clinical findings were not significantly different between the events and event-free groups. The GS and TID scores revealed significant differences between patient groups. Only the renal histological parameters of GS and events were statistically correlated with renal survival. We conclude that the severity of GS may be the important prognostic factor inpatients with IgAN accompanied by proteinuria at the time of the initial biopsy.
長崎大学の論文