IgA nephropathy in patients over 50 years of age: a multicentre, prospective study

Frimat, Luc; Hestin, D.; Aymard, B.; Mayeux, D.; Renoult, E.; Kessler, Michèle

doi:10.1093/ndt/11.6.1043

Cited by 14 publications

(20 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinicopathological features and outcomes of primary IgA nephropathy (IgAN) in the elderly population (>65 years old) have not been adequately evaluated. In a recent meta‐analysis gathering all searchable data, from 1980 to 2010, only nine studies of reasonable quality included elderly patients (four from Japan, one from France, one from Iran, one from Italy, one from Spain and one from China) . Among the nine studies, only a minority (<5%) of patients were elderly (age >50 or >65 years).…”

mentioning

confidence: 99%

Primary IgA nephropathy in elderly patients

et al. 2015

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Primary IgA nephropathy in elderly patients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Many literature sources suggest that age is also a prognostic factor, and old age is correlated with poor prognosis [28, 29]. A previous study compared patients of different ages (≥ 50 and <50 years old) and found a higher incidence of arterial intimal thickening in the elder group, but no differences in the degree of other pathological changes; the follow-up for 41 months showed no difference in survival [30]. …”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Features to Predict Progression of IgA Nephropathy with Mild Proteinuria

Ding

Liu

Duan

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: In the past, little attention has been paid to patients with IgA nephropathy (IgAN) who had minimal proteinuria upon the onset. The aim of this study was to analyze the clinicopathological features and the prognostic factors in patients with IgA nephropathy. Methods: Data of patients that had their first renal biopsy in our hospital and were diagnosed with primary IgAN with proteinuria <1 g/d from January 1995 to December 2014 were retrospectively examined. Clinical records of the clinicopathological features, renal function, and proteinuria were collected and investigated. The factors affecting the renal function and proteinuria were analyzed by Cox regression. The predictive efficiencies of clinical and pathological models were evaluated by Harrell concordance index (C-index). Results: A total of 506 patients with IgA nephropathy were included in this study. (1) Baseline proteinuria greater than 0.5 g/d was positively associated with Oxford M, S, and T lesions. eGFR less than 90 mL/min/1.73 m² were positively associated with Oxford T. (2) In the follow-up with a median of 50 months, 82 patients (16.2%) achieved complete clinical remission (CCR), whereas 54 patients (10.6%) showed an increase in creatinine by more than 50% (not progressing to end-stage renal disease). The cumulative proportion of creatinine increased >50%, and the values obtained by life-table analysis in 10, 15, and 20 years were 15%, 21%, and 22%, respectively. Significant differences were found in baseline age, proteinuria, and Oxford T between the group of creatinine increase >50% and the CCR group. (4) Multivariate COX regression showed that baseline age and proteinuria > 0.5 g/d were independent risk factors of adverse outcome. C-index suggested that the clinical model was more effective than the pathological models in predicting endpoint events. (5) Effect of the mean value during the follow-up on adverse endpoint events: Multivariate COX regression found that the mean proteinuria during follow-up was an independent influencing factor for the increase of creatinine by more than 50%. Conclusion: (1) Proteinuria > 0.5g/d and eGFR < 90 mL/min/1.73 m² may predict more severe pathological changes; (2) With the increase in age and baseline proteinuria, the risks of adverse endpoint events would increase significantly; (3) Pathology could roughly predict the adverse endpoint events but is less efficient than the clinical indicators; (4) Data during follow-up suggested that the patients should regularly test their renal function and proactively control their proteinuria.

show abstract

“…This is reflected in a 2012 meta‐analysis, showing only nine studies in the past three decades containing elderly patients . Only one of the nine studies was designed to evaluate IgA nephropathy in the elderly (aged ≥50 years), and of the 33 patients in that study, only 16 had limited histological information …”

Section: Iga Nephropathy In Elderly Patientsmentioning

confidence: 99%

“…33 Only one of the nine studies was designed to evaluate IgA nephropathy in the elderly (aged ≥50 years), and of the 33 patients in that study, only 16 had limited histological information. 34 A total of four publications have since been added to the literature (searchable and in English). They are discussed below and summarized in Table 1.…”

Section: Iga Nephropathy In Elderly Patientsmentioning

confidence: 99%

“…For the elderly, the incorporation of eGFR and age at the time of biopsy might be useful. In addition to ARR, there have been several ESRD prediction models and scoring systems for IgA nephropathy, generated from younger adults (mean age [30][31][32][33][34][35][36][37][38][39][40]. [57][58][59][60] They may not be suitable for elderly patients.…”

Section: Iga Nephropathy In Elderly Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Elderly patients with glomerular diseases and IgA nephropathy

2017

View full text Add to dashboard Cite

Summary at a Glance As the population ages, large numbers of elderly patients will present with kidney diseases. Kidney biopsy for elderly patients is generally well tolerated and informative. Compared with younger adults, IgA nephropathy in the elderly carries a poor prognosis. In patients with intercurrent infections, IgA‐dominant postinfectious GN should be carefully differentiated from idiopathic IgA nephropathy. Existing ESRD and mortality prediction models/scoring systems for IgA nephropathy may not be generalized to elderly patients.

show abstract

IgA nephropathy in patients over 50 years of age: a multicentre, prospective study

Cited by 14 publications

References 14 publications

Primary IgA nephropathy in elderly patients

Primary IgA nephropathy in elderly patients

Clinicopathological Features to Predict Progression of IgA Nephropathy with Mild Proteinuria

Elderly patients with glomerular diseases and IgA nephropathy

Contact Info

Product

Resources

About