Outcomes of normotensive IgA nephropathy patients with mild proteinuria who have impaired renal function

Abstract

Purpose: Typically, IgA nephropathy is a slowly progressive type of glomerulonephritis. Highgrade proteinuria and hypertension are predictors of reduced kidney function. However, we found some normotensive patients with mild proteinuria could exhibit impaired renal function at the time of IgAN diagnosis. We therefore conduct a study to highlight the occurrence of these cases and to define their clinical characteristics and outcomes. Methods: The clinical, laboratory, pathological manifestations and outcomes of these IgAN patients were collected and were compared with normotensive IgA nephropathy patients with mild proteinuria and normal renal function. Patients were analyzed according to different pathological characteristics. Survival curves were constructed according to the Kaplan-Meier method. Results: Of all normotensive IgA nephropathy patients with mild proteinuria, 108 (10.1%) patients had impaired renal function. Ischemic sclerosis (79 patients) and fibrous crescent (25 patients) were the main pathological characteristics. Macroscopic hematuria (1.3%), prodromal infection (13.9%) and high serum IgA (11.4%) were significantly lower prevalences, but only proteinuria (26.6%) was more common in ischemic sclerosis group patients. Only hematuria were not found in ischemic sclerosis group and crescent group patients. The median follow-up were about 5 years. Patients in crescent group had a poor outcome compared with patients in ischemic sclerosis group. Conclusions: Some normotensive IgA nephropathy patients with mild proteinuria had impaired renal function at diagnosis. Ischemic sclerosis and fibrous crescent were the main pathological features in these patients. Patients in the crescent group had a worse outcome than patients in the ischemic sclerosis group.

The Effectiveness and Safety of Abelmoschus manihot in Treating IgA Nephropathy: A Systematic Review and Meta-Analysis

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Rifaximin as a Potential Treatment for IgA Nephropathy in a Humanized Mice Model

“…IgA Nephropathy (IgAN) is a frequent cause of end-stage renal failure (about 20-40% of cases) [1] and it is characterized by dominant mesangial IgA deposition [2]. Microscopic hematuria and proteinuria are the most common clinical presentations [3]. Abnormally glycosylated IgA1 (Gd-IgA1) has a central role in the multi-hit process in IgAN patients [4].…”