Relative Risk Factors of Prognosis in IgA Nephropathy Patients with Depressed Renal Functions

Korean Journal of Nephrology 2010;29(2):198-207.

Sulra Lee, M.D., So Young Choi, M.D., Se-bin Song, M.D., Kyunghwan Jung, M.D., Taewon Lee, M.D. and Chunkyu Lim, M.D.

Division of Nephrology, Department of Internal Medicine Kyunghee University College of Medicine, Seoul Korea

원저 : 신기능이 저하된 IgA 신증 환자의 관련 위험 인자

이설라, 송세빈, 최소영, 정경환, 이태원, 임천규

경희대학교 의과대학 내과학교실, 신장내과학교실

Abstract

Purpose : This study was aimed at finding clinical factors to be associated with a progressive course of IgA nephropathy. Methods : We investigated the association between the prognosis of IgA nephropathy and clinical and laboratory findings including age, sex, hypertension, diabetes mellitus, 24-hour urine protein, macroscopic hematuria, hematuria duration, serum uric acid, serum creatinine, GFR, upper respiratory infection, pathological observation, and treatment protocols. One hundred seventy seven patients were followed up for more than 2 years at Kyung Hee university medical center from January 1997 through December 2006. Kidney size and echogenicity were measured by abdominal ultrasonography. Resistive index was calculated by doppler ultrasonography. Results : Long hematuria duration, increased uric acid, elevated creatinine of chronic renal failure group were distinguished from those of normal and acute renal failure group statistically. Using multivariate analysis, three factors, elevated serum uric acid, decreased GFR, ACE inhibitor or ARB and steroid combination treatment proved to be independent prognostic indicators of acute renal failure of IgA nephropathy. Heavy proteinuria, long hematuria duration, and severe histopathologic findings by Haas’ classification were associated with significant risk factors for developing chronic renal failure. Conclusion : At diagnosis of IgA nephropathy, hematuria continuation and histological damage in Haas’ classification were related with the reduction of renal function.

Key Words: IgA nephropathy, Prognosis