IgA nephropathy epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2] Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3]

Overview

IgA nephropathy is currently the most common cause of primary glomerulonephritis globally, and it is the most common primary chronic glomerulonephritis in the developed world. IgA nephropathy comprises approximately 10% of all biopsy-proven glomerulonephritis in the USA, 20% of those in Europe and 40-50% of those in Asia. The kidney biopsies are not routinely performed for all patients with kidney diseases; hence, IgA nephropathy is perhaps under-diagnosed, and its true prevalence remains unknown.

Epidemiology and Demographics

Prevalence

  • IgA nephropathy is currently the most common cause of primary glomerulonephritis globally. [1]
  • IgA nephropathy is the most common primary chronic glomerulonephritis in the developed world.
  • IgA nephropathy comprises approximately 10% of all biopsy-proven glomerulonephritis in USA, 20% of those in Europe and 40-50% of those in Asia.[2]
  • The kidney biopsies are not routinely performed for all patients with kidney diseases; hence, IgA nephropathy is perhaps under-diagnosed, and its true prevalence remains unknown.

Incidence

  • In 2013, the incidence of IgA nephropathy was estimated to be 3.9–4.5 cases per 100,000 individuals in Japan.[3]

Race

  • IgA nephropathy is found more commonly in Asians, Caucasians and people of Eastern Europe. It is very rare in Blacks and people of African descent.

Gender

  • IgA nephropathy seems to be more common among males with a 2:1 male to female ratio for both children and adults.[4][5]
  • The studies from Japan report an equal male to female ratio.[6]

Age

  • IgA nephropathy may present at any age although, it can occur in childhood.
  • IgA nephropathy is often found mostly in adult males in the second to third decade of life.
  • It is a frequently diagnosed glomerular disease in both the pediatric and the adult population.
  • The median age ranges between 30-40 years. Recently, IgA Nephropathy has shown an increase in incidence among patients in older age groups.[7]
  • Although the classical presentation of IgA nephropathy is gross hematuria in a young male patient following an upper respiratory tract infection, such findings are in fact only seen in 30-40% of the patients.[7] Atypical presentations are more common among older patients.
  • It is also noteworthy, that some studies have shown incidence of IgA nephropathy in about 3 -16% healthy individuals [8].
  • The renal biopsy of the healthy individuals showed evidence of immunogenic IgA deposit in the renal glomeruli without any evidence of kidney disease or systemic manifestation.

Geographical Distribution

  • IgA nephropathy is highly prevalent in the Pacific Rim in Europe and North America[7] and in the far East Asia, namely China and Japan.[9]

References

  1. Julian BA, Waldo FB, Rifai A, Mestecky J (1988). "IgA nephropathy, the most common glomerulonephritis worldwide. A neglected disease in the United States?". Am J Med. 84 (1): 129–32. PMID 3337116.
  2. Haubitz M, Wittke S, Weissinger EM, Walden M, Rupprecht HD, Floege J; et al. (2005). "Urine protein patterns can serve as diagnostic tools in patients with IgA nephropathy". Kidney Int. 67 (6): 2313–20. doi:10.1111/j.1523-1755.2005.00335.x. PMID 15882273.
  3. Sasaki, Kotaro; Anderson, Eric; Shankland, Stuart J.; Nicosia, Roberto F. (2013). "Diffuse Proliferative Glomerulonephritis Associated With Cetuximab, an Epidermal Growth Factor Receptor Inhibitor". American Journal of Kidney Diseases. 61 (6): 988–991. doi:10.1053/j.ajkd.2013.01.008. ISSN 0272-6386.
  4. Wyatt RJ, Kritchevsky SB, Woodford SY, Miller PM, Roy S, Holland NH; et al. (1995). "IgA nephropathy: long-term prognosis for pediatric patients". J Pediatr. 127 (6): 913–9. PMID 8523188.
  5. Wyatt RJ, Julian BA, Baehler RW, Stafford CC, McMorrow RG, Ferguson T; et al. (1998). "Epidemiology of IgA nephropathy in central and eastern Kentucky for the period 1975 through 1994. Central Kentucky Region of the Southeastern United States IgA Nephropathy DATABANK Project". J Am Soc Nephrol. 9 (5): 853–8. PMID 9596083.
  6. Feehally J, Cameron JS (2011). "IgA nephropathy: progress before and since Berger". Am J Kidney Dis. 58 (2): 310–9. doi:10.1053/j.ajkd.2011.03.024. PMID 21705126.
  7. 7.0 7.1 7.2 Barratt J, Feehally J (2005). "IgA nephropathy". J Am Soc Nephrol. 16 (7): 2088–97. doi:10.1681/ASN.2005020134. PMID 15930092.
  8. Suzuki K, Honda K, Tanabe K, Toma H, Nihei H, Yamaguchi Y (2003). "Incidence of latent mesangial IgA deposition in renal allograft donors in Japan". Kidney Int. 63 (6): 2286–94. doi:10.1046/j.1523-1755.63.6s.2.x. PMID 12753320.
  9. Hall YN, Fuentes EF, Chertow GM, Olson JL (2004). "Race/ethnicity and disease severity in IgA nephropathy". BMC Nephrol. 5: 10. doi:10.1186/1471-2369-5-10. PMC 517500. PMID 15341669.

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