Long-term prognosis of IgA nephropathy presenting with minimal or no proteinuria: A single center experience

Imai, Naohiko; Shirai, Sayuri; Yasuda, Takashi; Shibagaki, Yugo; Kimura, Kazumi

doi:10.4103/0971-4065.157010

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…In a Japanese study of 20 IgAN patients with normal renal function and proteinuria of < 0.5 g/day at diagnosis, the 15-year renal survival rate was 93.8%, and clinical remission was observed in 9 (45%) patients. Baseline proteinuria was associated with the absence of clinical remission [ 16 ]. Spontaneous remission, even in adult patients with IgAN with nephrotic syndrome, was reported in 2011 [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy

et al. 2021

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Background There are few studies describing the clinical course and spontaneous remission of IgA nephropathy (IgAN) in adult patients receiving conservative treatment. Method Data from 62 adult patients with biopsy-diagnosed IgAN, who received conservative treatment at least 5 years prior, were retrospectively investigated. No patients received corticosteroids, other immunosuppressants, or tonsillectomy. Remission of proteinuria and hematuria were defined as proteinuria <0.3 g/gCr and urine red blood cells (RBC) <5 / high power field (HPF) on three consecutive urinalyses obtained during an observation period of ≥6 months. Result Thirty-eight (61.3%) patients had remission of hematuria, 24 (38.7%) had remission of proteinuria, and 19 (30.6%) had remission of both. Remission rates increased in patients with proteinuria <0.5 g/g Cr at diagnosis. The median time to remission of hematuria was 2.8 years and that of proteinuria was 2.6 years. Patients who showed renal function decline (defined as 30% decline of estimated glomerular filtration rate [eGFR] from baseline) were older, had significantly lower eGFR, and higher proteinuria at diagnosis. Two patients with preserved renal function and normal proteinuria at diagnosis experienced renal function decline. Renal function did not decline within 3 years of diagnosis in patients with proteinuria <1 g/gCr at diagnosis. Conclusions Relatively high rates of spontaneous remission were observed. Remission of both hematuria and proteinuria were frequent within 3 years after diagnosis, and renal function was well preserved during this period. These data indicate that it is rational to use conservative treatment for 3 years after the diagnosis instead of aggressive treatments.

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Section: Discussionmentioning

confidence: 99%

Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy

et al. 2021

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“…The 10-year renal survival rate of IgAN patients ranges from 76% to 94%, and the 20-year renal survival rate ranges from 47% to 83% (5). About 30% of IgAN patients develop renal failure 20–30 years after the disease, and 1%–2% of the total number of patients diagnosed each year will enter end-stage renal failure (6).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Renin-Angiotensin Aldosterone System Inhibitor in Patients with IgA Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Zhao¹,

Fan²,

Bao³

2020

ijph

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Background: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) as the commonly used renin-angiotensin aldosterone system inhibitor are widely used in patients with IgA nephropathy (IgAN), but the effect is controversy. In this study, we used a meta-analysis to evaluate the efficacy and safety of ACEI and/or ARB for the patients with IgAN. Methods: Two investigators independently searched the PubMed, EMBASE, the Cochrane Library, EBSCO, and Wiley databases without language restrictions. We collected the clinical randomized controlled trials (RCTs) on “ACEI and/or ARB for the patients with IgAN” published before December 31, 2018, and performed data extraction and quality analysis on the included studies, and analyzed data using RevMan 5.2 software. Results: A total of 10 RCTs (635 patients) were included in our analysis. Alone use of ACEI (MD=-0.75, 95%CI: -1.28-0.21, P=0.006) or ARB (MD=-0.56, 95%CI: -0.82-0.30, P< 0.001) or a combination of ACEI and ARB (MD=-0.63, 95%CI: -0.87-0.38, P<0.001) significantly reduced the levels of proteinuria in patients with IgAN. However, whether using ACEI or ARB alone or in combination with ACEI and ARB, there was no significant effect on serum creatinine, 24-creatinine clearance and glomerular filtration rate in patients with IgAN. Conclusion: The use of ACEI and ARB significantly reduces the levels of proteinuria in patients with IgAN, but more large-sample RCTs with long-term follow-up are needed for confirming our results and guiding clinical treatment.

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Enumerating the role of properdin in the pathogenesis of IgA nephropathy and its possible therapies

Ghosh¹,

Das²,

Mukherjee³

et al. 2021

International Immunopharmacology

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Long-term prognosis of IgA nephropathy presenting with minimal or no proteinuria: A single center experience

Cited by 3 publications

References 17 publications

Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy

Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy

Efficacy and Safety of Renin-Angiotensin Aldosterone System Inhibitor in Patients with IgA Nephropathy: A Meta-Analysis of Randomized Controlled Trials

Enumerating the role of properdin in the pathogenesis of IgA nephropathy and its possible therapies

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