Primary IgA nephropathy in the Kashmiri population

Abstract

IgA nephropathy (IgAN) remains one of the most common glomerular lesions, which has a striking geographic distribution and is the most common form of primary glomerular disease in Asia. However, the exact prevalence or clinicopathological spectrum of IgAN in India is not well documented. This retrospective study analyzed the presentation in 126 patients of primary IgAN out of 298 native kidney biopsies (42.28%) performed over a period of three years (2013-2015). The patients were followed up for three months. This is the second highest prevalence recorded in the world after Japan. Among the clinical features of our cohort, the mean age was 31 years, with a male-to-female ratio of 2:1, with the highest incidence observed in the third decade of life in both sexes. The majority of our patients (47%) presented with renal failure with a mean serum creatinine value of 3.1 mg/dL and with burnt out morphology on histo-pathology; 72.2% of patients were hypertensive at presentation. On histopathology, Haas class V (35.5%) had the highest frequency followed by class IV (25.8%). The Oxford MEST score was not applicable in 36 patients because of advanced sclerosis (>50%). In the remaining ninety patients, majority had tubular atrophy and interstitial fibrosis of varying degrees. At three months of follow-up, the patients who had presented with renal failure (47.6%), settled in chronic kidney disease stage III (25.4%) followed by stage IV (18.6%) and stage V (11.8%). Our study in Kashmir suggests that IgAN is more common in the younger age group, with a significant number of patients presenting with advanced renal failure and, on morphology, showing a burnt out disease, with many developing end-stage renal disease. Studies evaluating the underlying factors can have immense importance in dealing with the disease.

Association between VDR gene FokI polymorphism and renal function in patients with IgA nephropathy

“…IgA nephropathy accounts for 40–47.2% of primary glomerular nephritis in China and is one of the most common primary glomerular diseases worldwide and an important cause of CRF (Wang et al, 2015; Wyatt & Julian, 2013). Our results indicated that 55.32% of IgAN patients have renal dysfunction, which is similar to the proportion of primary IgAN patients with renal failure in India (47%) (Chowdry et al, 2018). We also found that the VDR gene was closely related to elevated serum iPTH and P, and elevated iPTH and P were independent risk factors for renal dysfunction in IgAN.…”

Peer Review #1 of "Association between VDR gene FokI polymorphism and renal function in patients with IgA nephropathy (v0.1)"

“…IgAN accounts for 40%-47.2% of primary glomerular nephritis in China and is one of the most common primary glomerular diseases worldwide and an important cause of CRF (Wang et al 2015; Wyatt & Julian 2013). Our results indicated that 55.32% of IgAN patients have renal dysfunction, which is similar to the proportion of primary IgAN patients with renal failure in India (47%) (Chowdry et al 2018). We also found that the VDR gene was closely related to elevated serum iPTH and P, and elevated iPTH and P were independent risk factors for renal dysfunction in IgAN.…”

Should Corticosteroids be Used To Treat Biopsy-Proven Drug-Induced Acute Interstitial Nephritis?: COMMENTARY

“…Since this publication, other studies have added 295 patients, 274 of them receiving corticosteroids. One of them is the only prospective randomized study published to date, but it compared two forms of corticosteroid treatment, without an untreated control group 7 .…”