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. 2017 Aug 24;3(1):99-104.
doi: 10.1016/j.ekir.2017.08.008. eCollection 2018 Jan.

Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy

M Colleen Hastings  1   2   3 , Zoran Bursac  4   5 , Bruce A Julian  6 , Emanuel Villa Baca  7 , Jennifer Featherston  7 , Susan Y Woodford  6 , Lisa Bailey  1 , Robert J Wyatt  1   3
Affiliations

Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy

M Colleen Hastings et al. Kidney Int Rep. .

Abstract

Introduction: Although end-stage renal disease (ESRD) and surrogate markers for renal dysfunction are frequently used as outcome markers for IgA nephropathy, the clinical course after reaching ESRD is not well documented. This study examined outcomes of progression to ESRD and age at death in a cohort of adults with IgA nephropathy with a long duration of follow-up.

Methods: Patient and kidney survival of 251 adult patients with IgA nephropathy from the southeastern United States diagnosed between January 1, 1976 and December 31, 2005 were analyzed.

Results: Median age at diagnosis was 36.9 years. Most patients were men (69%) and Caucasian (95%). Only 46% had an estimated glomerular filtration rate >60 ml/min per 1.73 m2 at diagnosis. Mean follow-up time from time of diagnostic biopsy to death or end of study was 19.3 years. Of 251 patients, 132 (53%) progressed to ESRD and 97 (39%) died. Life expectancy was reduced by 10.1 years, with a median observed age of death at 65.7 years and a median expected age at death of 75.8 years. Eighty-three percent of the deaths occurred after progression to ESRD.

Conclusion: Life expectancy is substantially reduced for patients diagnosed with IgA nephropathy in the southeastern United States.

Keywords: IgA nephropathy; end-stage renal disease; glomerular disease; mortality; nephropathy progression.

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Figures

Figure 1
Figure 1
Outcomes for patients from central and eastern Kentucky with IgA nephropathy at the end of the study (December 31, 2015). Chronic kidney disease (CKD) stage for those not reaching end-stage renal disease (ESRD) was at the last clinic visit that was often many years before the end of the study.
Figure 2
Figure 2
Survival in years from diagnostic kidney biopsy to date of death (red line) and to end-stage renal disease (ESRD) defined by the need for chronic dialysis or transplantation (blue line). The numbers of at-risk patients at each 5-year interval are shown below for both survival curves.
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