IgA nephropathy natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
* | Complications of IgA nephropathy are generally those of renal injury. | ||
* | *Hypertension | ||
* | *Nephritic syndrome | ||
*Nephrotic syndrome | |||
*Acute kidney injury | |||
*Chronic kidney disease | |||
*End-stage renal disease | |||
*Hypercholesterolemia | |||
==Prognosis== | ==Prognosis== | ||
Male gender, [[proteinuria]] (especially > 2 g/day), [[hypertension]], [[Tobacco smoking|smoking]], [[hyperlipidemia]], older age, familial disease and elevated [[creatinine]] concentrations are markers of a poor outcome. Frank [[hematuria]] has shown discordant results with most studies showing a better prognosis, perhaps related to the early diagnosis, except for one group which reported a poorer prognosis. [[Proteinuria]] and [[hypertension]] are the most powerful prognostic factors in this group{{ref|Bartosik}}. | Male gender, [[proteinuria]] (especially > 2 g/day), [[hypertension]], [[Tobacco smoking|smoking]], [[hyperlipidemia]], older age, familial disease and elevated [[creatinine]] concentrations are markers of a poor outcome. Frank [[hematuria]] has shown discordant results with most studies showing a better prognosis, perhaps related to the early diagnosis, except for one group which reported a poorer prognosis. [[Proteinuria]] and [[hypertension]] are the most powerful prognostic factors in this group{{ref|Bartosik}}. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural History
The clinical course of IgA nephropathy varies widely between patients. Although it is generally regarded as a benign disease, emerging data has shown that progression to ESRD and death are more common than originally believed.[1] Some patients rapidly progress into ESRD; but the majority experience a stable kidney function following diagnosis.[1] Commonly, the progression of IgA nephropathy is slower than other notorious glomerular disease. Approximately 20-30% of patients with IgA nephropathy progress to ESRD after 10 years[1] and up to 30-50% of patients develop ESRD over 20 years.[2][3]
Complications
Complications of IgA nephropathy are generally those of renal injury.
- Hypertension
- Nephritic syndrome
- Nephrotic syndrome
- Acute kidney injury
- Chronic kidney disease
- End-stage renal disease
- Hypercholesterolemia
Prognosis
Male gender, proteinuria (especially > 2 g/day), hypertension, smoking, hyperlipidemia, older age, familial disease and elevated creatinine concentrations are markers of a poor outcome. Frank hematuria has shown discordant results with most studies showing a better prognosis, perhaps related to the early diagnosis, except for one group which reported a poorer prognosis. Proteinuria and hypertension are the most powerful prognostic factors in this group[2]. There are certain other features on kidney biopsy such as interstitial scarring which are associated with a poor prognosis. ACE gene polymorphism has been recently shown to have an impact with the DD genotype associated more commonly with progression to renal failure.
References
- ↑ 1.0 1.1 1.2 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.
- ↑ Velo M, Lozano L, Egido J, Gutierrez-Millet V, Hernando L (1987). "Natural history of IgA nephropathy in patients followed-up for more than ten years in Spain". Semin Nephrol. 7 (4): 346–50. PMID 3445013.
- ↑ Radford MG, Donadio JV, Bergstralh EJ, Grande JP (1997). "Predicting renal outcome in IgA nephropathy". J Am Soc Nephrol. 8 (2): 199–207. PMID 9048338.