Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct;23(10):1753-60.
doi: 10.1681/ASN.2012010063. Epub 2012 Sep 6.

Long-term outcomes of IgA nephropathy presenting with minimal or no proteinuria

Eduardo Gutiérrez  1 , Isabel Zamora, José Antonio Ballarín, Yolanda Arce, Sara Jiménez, Carlos Quereda, Teresa Olea, Jorge Martínez-Ara, Alfons Segarra, Carmen Bernis, Asunción García, Marian Goicoechea, Soledad García de Vinuesa, Jorge Rojas-Rivera, Manuel Praga; Grupo de Estudio de Enfermedades Glomerulares de la Sociedad Española de Nefrología (GLOSEN)
Affiliations

Long-term outcomes of IgA nephropathy presenting with minimal or no proteinuria

Eduardo Gutiérrez et al. J Am Soc Nephrol. 2012 Oct.

Abstract

The long-term outcome of patients with IgA nephropathy who present with normal renal function, microscopic hematuria, and minimal or no proteinuria is not well described. Here, we studied 141 Caucasian patients with biopsy-proven IgA nephropathy who had minor abnormalities at presentation and a median follow-up of 108 months. None of the patients received corticosteroids or immunosuppressants. We reviewed renal biopsies using the Oxford classification criteria. In this sample, 46 (32%) patients had mesangial proliferation, whereas endocapillary proliferation, focal glomerulosclerosis, and tubulointerstitial abnormalities were uncommon. Serum creatinine increases >50% and >100% were observed in five (3.5%) patients and one (0.7%) patient, respectively; no patients developed ESRD. After 10, 15, and 20 years, 96.7%, 91.9%, and 91.9% of patients maintained serum creatinine values less than a 50% increase, respectively. Using Cox proportional hazards regression, the presence of segmental glomerulosclerosis was the only factor that significantly associated with a >50% increase in serum creatinine. Clinical remission occurred in 53 (37.5%) patients after a median of 48 months. Proteinuria>0.5 and >1.0 g/24 h developed in 21 (14.9%) and 6 (4.2%) patients, respectively. Median proteinuria at the end of follow-up was 0.1 g/24 h, with 41 (29.1%) patients having no proteinuria. At presentation, 23 (16.3%) patients were hypertensive compared with 30 (21.3%) patients at the end of follow-up; 59 (41.8%) patients were treated with renin-angiotensin blockers because of hypertension or increasing proteinuria. In summary, the long-term prognosis for Caucasian patients with IgA nephropathy who present with minor urinary abnormalities and normal renal function is excellent.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Renal survival (defined by a status free of >50% and >100% baseline SCr increase).
Figure 2.
Figure 2.
Probability of absence of proteinuria>0.5 and >1.0 g/24 h during follow-up.
See this image and copyright information in PMC

Comment in

References

    1. D’Amico G: Natural history of idiopathic IgA nephropathy: Role of clinical and histological prognostic factors. Am J Kidney Dis 36: 227–237, 2000 - PubMed
    1. Alamartine E, Sabatier JC, Guerin C, Berliet JM, Berthoux F: Prognostic factors in mesangial IgA glomerulonephritis: An extensive study with univariate and multivariate analyses. Am J Kidney Dis 18: 12–19, 1991 - PubMed
    1. Berthoux F, Mohey H, Laurent B, Mariat C, Afiani A, Thibaudin L: Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol 22: 752–761, 2011 - PMC - PubMed
    1. Bartosik LP, Lajoie G, Sugar L, Cattran DC: Predicting progression in IgA nephropathy. Am J Kidney Dis 38: 728–735, 2001 - PubMed
    1. Reich HN, Troyanov S, Scholey JW, Cattran DC; Toronto Glomerulonephritis Registry: Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol 18: 3177–3183, 2007 - PubMed

Publication types

LinkOut - more resources