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
. 2018 Feb;11(1):38-45.
doi: 10.1093/ckj/sfx076. Epub 2017 Jul 31.

IgA nephropathy in Greece: data from the registry of the Hellenic Society of Nephrology

Maria Stangou  1 , Marios Papasotiriou  2 , Dimitrios Xydakis  3 , Theodora Oikonomaki  4 , Smaragdi Marinaki  5 , Synodi Zerbala  6 , Constantinos Stylianou  7 , Pantelitsa Kalliakmani  2 , Aimilios Andrikos  8 , Antonia Papadaki  9 , Olga Balafa  10 , Spyridon Golfinopoulos  11 , Georgios Visvardis  12 , Georgios Moustakas  13 , Evangelos Papachristou  2 , Theodora Kouloukourgiotou  1 , Eleni Kapsia  5 , Angeliki Panagiotou  6 , Constantinos Koulousios  8 , Christos Kavlakoudis  12 , Maria Georgopoulou  13 , Stylianos Panagoutsos  14 , Demetrios V Vlahakos  15 , Theophanis Apostolou  4 , Ioannis Stefanidis  11 , Kostas Siamopoulos  10 , Ioannis Tzanakis  9 , Apostolos Papadogiannakis  3 , Eugene Daphnis  7 , Christos Iatrou  6 , John N Boletis  5 , Aikaterini Papagianni  1 , Dimitrios S Goumenos  2
Affiliations

IgA nephropathy in Greece: data from the registry of the Hellenic Society of Nephrology

Maria Stangou et al. Clin Kidney J. 2018 Feb.

Abstract

Background: Natural history, predisposing factors to an unfavourable outcome and the effect of various therapeutic regimens were evaluated in a cohort of 457 patients with immunoglobulin A nephropathy (IgAN) and follow-up of at least 12 months.

Methods: Patients with normal renal function and proteinuria <1 g/24 h as well as those with serum creatinine (SCr) >2.5 mg/dL and/or severe glomerulosclerosis received no treatment. Patients with normal or impaired renal function and proteinuria >1 g/24 h for >6 months received daily oral prednisolone or a 3-day course of intravenous (IV) methylprednisolone followed by oral prednisolone per os every other day or a combination of prednisolone and azathioprine. The clinical outcome was estimated using the primary endpoints of end-stage renal disease and/or doubling of baseline SCr.

Results: The overall 10-year renal survival was 90.8%, while end-stage renal disease and doubling of baseline SCr developed in 9.2% and 14.7% of patients, respectively. Risk factors related to the primary endpoints were elevated baseline SCr, arterial hypertension, persistent proteinuria >0.5 g/24 h and severity of tubulointerstial fibrosis. There was no difference in the clinical outcome of patients treated by the two regimens of corticosteroids; nevertheless, remission of proteinuria was more frequent in patients who received IV methylprednisolone (P = 0.000). The combination of prednisolone with azathioprine was not superior to IV methylprednisolone followed by oral prednisolone. Side effects related to immunossuppressive drugs were observed in 12.8% of patients.

Conclusion: The clinical outcome of patients with IgAN was related to the severity of clinical and histological involvement. The addition of azathioprine to a corticosteroid-based regimen for IgAN does not improve renal outcome.

Keywords: IgA nephropathy; albuminuria; chronic renal failure; immunosuppressive drugs; prognosis.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
(A) Cumulative renal survival free from the endpoints of ESRD) and (B) doubling of baseline SCr in all patients.
Fig. 2.
Fig. 2.
MEST classification and primary endpoints. (A) Segmental glomerulosclerosis (S0/S1) in the kidney biopsy and survival free from ESRD or (B) doubling of baseline SCr. (C) Tubular atrophy/interstitial fibrosis (T0/T1/T2) in the kidney biopsy and survival free from ESRD or (D) doubling of baseline SCr.
Fig. 3.
Fig. 3.
Survival free from the endpoint of ESRD in patients with no substantial proteinuria, patients with remission and patients with no remission of proteinuria.
See this image and copyright information in PMC

References

    1. D’Amico G. The commonest glomerulonephritis in the world: IgA nephropathy. Q J Med 1987; 64: 709–727 - PubMed
    1. Donadio JV, Grande JP.. IgA nephropathy. N Engl J Med 2002; 347: 738–748 - PubMed
    1. Barratt J, Feehaly J.. IgA nephropathy. J Am Soc Nephrol 2005; 16: 2088–2097 - PubMed
    1. Haas MJ. Histology and immunohistology of IgA nephropathy. J Nephrol 2005; 18: 676–680 - PubMed
    1. D’Amico G. Influence of clinical and histological features οn actuarial renal survival in adult patients with idiopathic IgA nephropathy, membranous nephropathy and membranoproliferative glomerulonephritis: survey of the recent literature. Am J Kidney Dis 1992; 20: 315–323 - PubMed