IgA nephropathy in Brazil: apropos of 600 cases

Abstract

IgA nephropathy (IgAN) is th e commonest primary glomerular disease worldwide. Studies on its prevalence in Brazil are however scarce. Databases and clinical records from 10 reference centres were retrospectively reviewed. Clinical and laboratory features at the moment of the biopsy were retrieved (age, gender, presence of hematuria, serum creatinine [mg/dL], proteinuria [g/24 h]). Renal biopsy findings were classified according to Haas single grade classification scheme and the Oxford Classification of IgAN. 600 cases of IgAN were identified, of which 568 (94.7 %) were on native kidneys. Male to female ratio was 1.24:1. Patients averaged 32.76 ± 15.12 years old (range 4–89, median 32). Proteinuria and hematuria were observed, respectively in 56.63 and 72.29 % of patients. The association of both these findings occurred in 37.95 % of the cases. Serum creatinine averaged 1.65 ± 0.67 mg/dL (median 1.5 mg/dL) at diagnosis. Segmental sclerosis and mesangial hypercellularity were the main glomerular findings (47.6 and 46.2 %) The commonest combination by Oxford Classification of IgAN, was M0 E0 S0 T0 (22.4 %). Chronic tubulo-interstitial lesions with an extension wider than 25 % of the renal cortex could be identified in 32.2 % of the cases. Tubular atrophy and interstitial fibrosis were more strongly associated with higher 24-h proteinuria and serum creatinine levels. Segmental sclerosis (S1) showed a stronger tendency of association with the presence of tubulo-interstitial lesions (T1 and T2) than other glomerular variables. To the best of our knowledge this is the largest series of IgAN in Brazil. It depicts the main biopsy findings and their possible clinical correlates. Our set of data is comparable to previous reports.

IgA nephropathy in Salvador, Brazil: a more aggressive disease?

“… 4 The Paulista Registry of Glomerulonephritis reported the prevalence of 17.8% 5 and IgAN accounts for varying ranges of 2-25% of primary glomerulonephritis, according to other local reports. 5 , 6 …”

Distribution of kidney diseases in Joinville, Santa Catarina: analysis of a kidney biopsy data bank between 2008 and 2019

“…It is known that IgAN is more prevalent among men than women (2:1 ratio) among North American and European individuals 25 . In Brazil, based on a review of 600 IgA cases, it is estimated that the IgAN prevalence ratio among men and women is in the order of 1.24:1 26 . Advancing age and being male were protective factors for the occurrence of LGN in our sample.…”

Caracterización clínico-patológica en pacientes con diagnóstico histológico de nefropatía por IgA en la Región Caribe Colombiana

“…Así, los pacientes con un Score menor de 8 puntos tuvieron un riesgo de 1 % de evolucionar a la ERC a los 5 años, los que presentaron un Score entre 8 y 15 puntos tuvieron una incidencia de menos del 25 %, entre 15 y 22 puntos entre 25 % y 50 % y mayor de 22 puntos mayor al 50 % (17,18). Por su parte, Soares y col. (19), en su estudio demuestran que la esclerosis segmentaria y la hipercelularidad mesangial fueron los principales hallazgos glomerulares (47,6 % y 46,2 %), mientras que en nuestros hallazgos solo se reporta la hipercelularidad mensangial. Para estos mismos autores la combinación más común según la clasificación de Oxford de IgAN fue de M0 E0 S0 T0 (22,4 %), presentándose esta misma combinación en 4 casos en el presente estudio.…”