Prognostic factors of IgA nephropathy presenting with mild proteinuria at the time of diagnosis (a multicenter cohort study)
© 2023. The Author(s)..
BACKGROUND: Clinical factors affecting renal prognosis in patients with immunoglobulin A nephropathy (IgAN) and low urinary protein excretion (U-Prot) remain unclear. This study evaluated such factors in patients with clinical grade I (CG-I) IgAN with U-Prot < 0.5 g/day.
METHODS: This secondary analysis of a previous retrospective study included 394 patients with CG-I IgAN. The primary outcome was the first occurrence of a 1.5-fold increase in serum creatinine levels from baseline. Factors related to renal prognosis were examined using univariate and multivariate Cox regression analyses. CG-I was divided into C-Grade Ia (CG-Ia) (n = 330) with baseline eGFR ≥ 60 ml/min/1.73 m2, and C-Grade Ib (CG-Ib) (n = 64) with baseline eGFR < 60 ml/min/1.73 m2. Outcome incidence was compared between conservative and aggressive therapy (corticosteroids and/or tonsillectomy) groups.
RESULTS: Overall outcome incidence was significantly higher in CG-Ib than in CG-Ia; the cumulative incidence was significantly higher in CG-Ib (hazard ratio, 9.67; 95% confidence interval, 2.90-32.23). Older age, higher IgA levels, eGFR < 60 mL/min/1.73 m2, lower eGFR at baseline were independent prognostic factors for CG-I. Older age, lower eGFR, higher IgA levels at baseline, and U-Prot remission at 1-year post-diagnosis were independent prognostic factors for CG-Ib. Aggressive therapy tended to suppress the cumulative outcome incidence compared with conservative therapy in CG-Ib (p = 0.087).
CONCLUSION: An eGFR < 60 mL/min/1.73 m2 is a significant predictor of renal prognosis in patients with IgAN and U-Prot < 0.5 g/day.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Clinical and experimental nephrology - 27(2023), 4 vom: 27. Apr., Seite 340-348 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shirai, Sayuri [VerfasserIn] |
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| Links: |
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| Themen: |
IgA nephropathy |
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| Anmerkungen: |
Date Completed 21.03.2023 Date Revised 21.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10157-023-02316-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM352162767 |
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| 100 | 1 | |a Shirai, Sayuri |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic factors of IgA nephropathy presenting with mild proteinuria at the time of diagnosis (a multicenter cohort study) |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: Clinical factors affecting renal prognosis in patients with immunoglobulin A nephropathy (IgAN) and low urinary protein excretion (U-Prot) remain unclear. This study evaluated such factors in patients with clinical grade I (CG-I) IgAN with U-Prot < 0.5 g/day | ||
| 520 | |a METHODS: This secondary analysis of a previous retrospective study included 394 patients with CG-I IgAN. The primary outcome was the first occurrence of a 1.5-fold increase in serum creatinine levels from baseline. Factors related to renal prognosis were examined using univariate and multivariate Cox regression analyses. CG-I was divided into C-Grade Ia (CG-Ia) (n = 330) with baseline eGFR ≥ 60 ml/min/1.73 m2, and C-Grade Ib (CG-Ib) (n = 64) with baseline eGFR < 60 ml/min/1.73 m2. Outcome incidence was compared between conservative and aggressive therapy (corticosteroids and/or tonsillectomy) groups | ||
| 520 | |a RESULTS: Overall outcome incidence was significantly higher in CG-Ib than in CG-Ia; the cumulative incidence was significantly higher in CG-Ib (hazard ratio, 9.67; 95% confidence interval, 2.90-32.23). Older age, higher IgA levels, eGFR < 60 mL/min/1.73 m2, lower eGFR at baseline were independent prognostic factors for CG-I. Older age, lower eGFR, higher IgA levels at baseline, and U-Prot remission at 1-year post-diagnosis were independent prognostic factors for CG-Ib. Aggressive therapy tended to suppress the cumulative outcome incidence compared with conservative therapy in CG-Ib (p = 0.087) | ||
| 520 | |a CONCLUSION: An eGFR < 60 mL/min/1.73 m2 is a significant predictor of renal prognosis in patients with IgAN and U-Prot < 0.5 g/day | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a IgA nephropathy | |
| 650 | 4 | |a Mild proteinuria | |
| 650 | 4 | |a Renal prognosis | |
| 650 | 7 | |a Immunoglobulin A |2 NLM | |
| 700 | 1 | |a Yasuda, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Kumagai, Hiroo |e verfasserin |4 aut | |
| 700 | 1 | |a Matsunobu, Hanako |e verfasserin |4 aut | |
| 700 | 1 | |a Ichikawa, Daisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Shibagaki, Yugo |e verfasserin |4 aut | |
| 700 | 1 | |a Yasuda, Yoshinari |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuzaki, Keiichi |e verfasserin |4 aut | |
| 700 | 1 | |a Hirano, Keita |e verfasserin |4 aut | |
| 700 | 1 | |a Kawamura, Tetsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Yusuke |e verfasserin |4 aut | |
| 700 | 1 | |a Maruyama, Shoichi |e verfasserin |4 aut | |
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