Good Long-Term Prognosis for Benign IgA Nephropathy
(HealthDay News) – The long-term prognosis for Caucasian patients with immunoglobulin A (IgA) nephropathy with benign presentation (consisting of only minor urinary abnormalities and normal renal function) is excellent, without special treatment, according to research published online Sept 6 in the Journal of the American Society of Nephrology.
Eduardo Gutiérrez, MD, of the Hospital 12 de Octubre in Madrid, and colleagues conducted a long-term study involving 141 Caucasian patients with biopsy-proven IgA nephropathy with normal kidney function, minor abnormalities at presentation, and who were not taking immunosuppressants or corticosteroids. Participants were followed for a median of 108 months.
After 10, 15, and 20 years, the researchers found that 96.7%, 91.9%, and 91.9% of patients, respectively, maintained serum creatinine levels below a 50% increase from baseline. No patient developed end-stage renal disease. After a median of 48 months of follow-up, clinical remission had occurred in 37.5% of patients. At the end of follow-up, the median proteinuria was 0.1g/24 hours and 29.1% of patients had no proteinuria. Hypertension increased from 16.3% at presentation to 21.3% at the end of the study. Overall, 41.8% of patients were treated with renin-angiotensin blockers.
"Renal function decline was exceptional, whereas sustained clinical remission was observed in more than one-third of the patients," the authors write. "Increasing proteinuria to >1g/24 hours and hypertension were observed in a minority of patients."