Prognosis of IgA Nephropathy with No Proteinuria on Routine Urinalysis.
- Author:
Jong Bin KIM
1
;
Jung Min KIM
;
Young Ki SON
;
Su Mi LEE
;
Hye In KIM
;
Won Suk AN
;
Seong Eun KIM
;
Ki Hyun KIM
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kimkh@dau.ac.kr
- Publication Type:Original Article
- Keywords:
IgA nephropathy;
Remission;
Proteinuria;
Prognosis
- MeSH:
Follow-Up Studies;
Glomerulonephritis, IGA;
Humans;
Immunoglobulin A;
Kidney Failure, Chronic;
Prognosis;
Proteinuria;
Remission, Spontaneous;
Retrospective Studies;
Risk Factors;
Urinalysis
- From:Korean Journal of Nephrology
2010;29(6):702-707
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In patients with IgA nephropathy, more than 1 g/day of proteinuria is a risk factor to develop end-stage renal failure. Uncommonly, patients with IgA nephropathy exhibit negative proteinuria on routine dipstick test during follow-up examination, spontaneously or after use of ACEI or ARB. We evaluated whether no proteinuric patients have good prognosis or not. METHODS: 41 patients who had no proteinuria on routine urinalysis for more than 6 months, were classified into spontaneous remission group (25 cases, SR) without any treatment and drug-induced remission group (16 cases, DR) with treatment of ACEI/ARB or both, were analyzed for clinical findings and renal function, retrospectively. We examined spot urine protein/creatinine ratio (Up/c) to evaluate exact amount of proteinuria and GFR was estimated by MDRD equation. RESULTS: Twenty eight percent of cases in SR and 50 percent in DR showed spot Up/c 0.3-1 g/g. After follow-up of 58+/-41 (9-192) months in SR and 79+/-56 (35-192) months in DR, the stages of CKD shifted to advanced levels as follows; in SR group, 11, 10, 4 patients in stage 1 (GFR> or =90 ml/min/ 1.73m2), 2 (GFR 60-89 ml/min/1.73m2), 3 (GFR 30-59 ml/min/1.73m2) to 7, 13, 5 patients, respectively; in DR, 7, 8, 1 patients in stage 1, 2, 3 to 3, 8, 5 patients, respectively. There was a tendency of slow decreasing GFR in both groups but no case progressed to CKD stage 4 and 5. CONCLUSION: Of IgA nephropathy patients with no proteinuria on routine urinalysis, 30-50% of patients have proteinuria 0.3-1.0 g/g on spot Up/c and there was also a risk of progression.
