IgA Nephropathy: A Twenty Year Retrospective Single Center Experience

Abstract

IgA nephropathy (IgAN) is a common glomerular disease whose etiology is unknown. Previous studies have described the clinical and laboratory features but none have specifically compared patients during different time periods. This 20 year retrospective study was performed to assess trends in the severity of IgAN from 1989–2008. We reviewed 57 patient charts that contained a confirmed biopsy diagnosis of IgAN and recorded data at the time of diagnosis and the final follow-up appointment. Clinical data included physical examination, urine, and blood tests. Patients were separated into two cohorts, Cohort 1 1989–1998 and Cohort 2 1999–2008. An increase in severity was noted in Cohort 2 based on a significantly higher Up/c and lower serum albumin level. Other prognostic indicators including GFRe, hematocrit, and glomerular injury score also demonstrated a trend towards more severe disease over the past 20 years. The patients in both Cohorts received similar treatments and had comparable renal function at the last follow-up visit. Based on our findings, we suggest that although a kidney biopsy is required to diagnose IgAN, the procedure may not be necessary in patients clinically suspected of having the disease but who have normal kidney function and minimal urine abnormalities.

Increasing prescription of renin–angiotensin–aldosterone system blockers associated with improved kidney prognosis in Korean IgA nephropathy patients

“…IgAN has been widely recognized since the 1970s [ 3 , 4 ] and previous studies have since improved clinical practices and reported useful treatment strategies for the disease, particularly the maximum usage of renin–angiotensin–aldosterone system (RAAS) blockers as a standard of care [ 5–8 ]. Although the understanding of the disease has advanced, there has been limited research investigating the time trends of characteristics and prognosis of IgAN with a sufficient number of patients [ 9 , 10 ]. As the population structure is changing and clinical guidelines have been developed [ 11 ], a study investigating whether any distinct features are present in the different time periods regarding IgAN may provide insights regarding future disease trends.…”