First-year GFR slope and long-term renal outcome in IgA nephropathy

被引:11
|
作者
Lee, Kyungho [1 ]
Shin, Jungho [2 ]
Park, Jeeeun [1 ]
Hwang, Subin [1 ]
Jang, Hye Ryoun [1 ]
Huh, Wooseong [1 ]
Kwon, Ghee Young [3 ]
Kim, Yoon-Goo [1 ]
Oh, Ha Young [1 ]
Lee, Jung Eun [1 ]
Kim, Dae Joong [1 ]
机构
[1] Sungkyunkwan Univ, Div Nephrol, Sch Med, Dept Med,Samsung Med Ctr, Seoul, South Korea
[2] Chung Ang Univ, Div Nephrol, Sch Med, Dept Internal Med, Seoul, South Korea
[3] Sungkyunkwan Univ, Dept Pathol, Sch Med, Samsung Med Ctr, Seoul, South Korea
关键词
chronic kidney disease; glomerulonephritis; IgA nephropathy; prognosis; risk factor; OXFORD CLASSIFICATION; VALIDATION; DECLINE; RISK; PROGRESSION; PATHOLOGY; THERAPY;
D O I
10.1111/eci.12936
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundIgA nephropathy (IgAN) is the most frequent primary glomerular disease and the leading cause of end-stage renal disease. We investigated clinicopathologic predictors of renal survival in patients with IgAN with a focus on glomerular filtration rate (GFR) decline slope. Materials and methodsWe screened all patients with primary IgAN between 1995 and 2012. Renal progression was defined as doubling of serum creatinine. Using serial serum creatinine levels during the first-year, we calculated the GFR decline slopes. Further, we defined patients in the steepest GFR slope quartile as rapid decliners and those in the second steepest GFR slope quartile as slow decliners. Others were defined as nondecliners. ResultsOf 214 participants, baseline GFR was 81 (62, 100)mL/min/1.73m(2), which was not different among the 3 groups. Rapid decliners and slow decliners had higher levels of urinary protein/creatinine ratio (0.88, 0.89 and 0.58g/gCr, respectively, P<.001). Five-year renal survival was 76% in rapid decliners, 91% in slow decliners and 100% in nondecliners (P<.001, rapid or slow decliners vs nondecliners). After adjustment for clinicopathologic variables, slow decliners were associated with an 8.8-fold higher risk of progression (P=.011), and rapid decliners were associated with a 10.2-fold increased risk of progression (P=.007) compared with nondecliners. ConclusionsFirst-year GFR slope was associated with increased risk of renal progression, independent of proteinuria and histologic findings. Further studies are needed to investigate whether early GFR change can identify high-risk patients who benefit from immunosuppressive treatment in IgAN.
引用
收藏
页数:8
相关论文
共 50 条
  • [1] CLINICAL PRESENTATION OF IGA NEPHROPATHY AND LONG-TERM RENAL OUTCOME
    Stefan, Gabriel
    Stancu, Simona
    Zugravu, Adrian Dorin
    Petre, Nicoleta
    Mircescu, Gabriel
    NEPHROLOGY DIALYSIS TRANSPLANTATION, 2021, 36
  • [2] The association of 5-year therapeutic responsiveness with long-term renal outcome in IgA nephropathy
    Tsushima, Hideo
    Samejima, Ken-ichi
    Eriguchi, Masahiro
    Uemura, Takayuki
    Tasaki, Hikari
    Fukata, Fumihiro
    Nishimoto, Masatoshi
    Kosugi, Takaaki
    Tanabe, Kaori
    Okamoto, Keisuke
    Matsui, Masaru
    Tsuruya, Kazuhiko
    CLINICAL AND EXPERIMENTAL NEPHROLOGY, 2022, 26 (08) : 797 - 807
  • [3] The association of 5-year therapeutic responsiveness with long-term renal outcome in IgA nephropathy
    Hideo Tsushima
    Ken-ichi Samejima
    Masahiro Eriguchi
    Takayuki Uemura
    Hikari Tasaki
    Fumihiro Fukata
    Masatoshi Nishimoto
    Takaaki Kosugi
    Kaori Tanabe
    Keisuke Okamoto
    Masaru Matsui
    Kazuhiko Tsuruya
    Clinical and Experimental Nephrology, 2022, 26 : 797 - 807
  • [4] The Long-Term Renal Outcome and Pregnancy Complications with Kidney Transplantation of IgA Nephropathy
    Oki, R.
    Unagami, K.
    Kakogawa, J.
    Beppu, H.
    Banno, T.
    Yagisawa, T.
    Hirai, T.
    Omoto, K.
    Kitajima, K.
    Shirakawa, H.
    Hoshino, J.
    Takagi, T.
    Ishida, H.
    AMERICAN JOURNAL OF TRANSPLANTATION, 2023, 23 (06) : S709 - S709
  • [5] First-Year Renal Function Predicts Long-Term Renal Allograft Loss
    Fonseca, I.
    Almeida, M.
    Martins, L. S.
    Santos, J.
    Dias, L.
    Lobato, L.
    Henriques, A. C.
    Mendonca, D.
    TRANSPLANTATION PROCEEDINGS, 2011, 43 (01) : 106 - 112
  • [6] IgA Nephropathy Histopathology and Long-Term Renal Prognosis
    Maddy, Nora C.
    Nee, Robert
    Gordon, Sarah M.
    Olson, Stephen W.
    JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2021, 32 (10): : 496 - 496
  • [7] The long-term outcome of renal transplantation of IgA nephropathy and the impact of recurrence on graft survival
    Moroni, Gabriella
    Longhi, Selena
    Quaglini, Silvana
    Gallelli, Beniamina
    Banfi, Giovanni
    Montagnino, Giuseppe
    Messa, Piergiorgio
    NEPHROLOGY DIALYSIS TRANSPLANTATION, 2013, 28 (05) : 1305 - 1314
  • [8] Long-term outcome of childhood IgA nephropathy with minimal proteinuria
    Asumi Higa
    Yuko Shima
    Taketsugu Hama
    Masashi Sato
    Hironobu Mukaiyama
    Hiroko Togawa
    Ryojiro Tanaka
    Kandai Nozu
    Mayumi Sako
    Kazumoto Iijima
    Koichi Nakanishi
    Norishige Yoshikawa
    Pediatric Nephrology, 2015, 30 : 2121 - 2127
  • [9] COURSE AND LONG-TERM OUTCOME OF IDIOPATHIC IGA NEPHROPATHY IN CHILDREN
    LINNE, T
    BERG, U
    BOHMAN, SO
    SIGSTROM, L
    PEDIATRIC NEPHROLOGY, 1991, 5 (04) : 383 - 386
  • [10] Long-term outcome of childhood IgA nephropathy with minimal proteinuria
    Higa, Asumi
    Shima, Yuko
    Hama, Taketsugu
    Sato, Masashi
    Mukaiyama, Hironobu
    Togawa, Hiroko
    Tanaka, Ryojiro
    Nozu, Kandai
    Sako, Mayumi
    Iijima, Kazumoto
    Nakanishi, Koichi
    Yoshikawa, Norishige
    PEDIATRIC NEPHROLOGY, 2015, 30 (12) : 2121 - 2127