Is it Possible to Predict the Progression Rate in Korean IgA Nephropathy Patient?.
- Author:
Young Soo SONG
1
;
Jung Eun KIM
;
Ji Eun PARK
;
Yongjun CHOI
;
Heesun JUNG
;
Mi Jung KIM
;
Byung Kook IM
;
Hyuck Joon CHUNG
;
Hyunee YIM
;
Gyu Tae SHIN
;
Heungsoo KIM
Author Information
1. Department of Nephrology, Ajou University School of Medicine, Suwon, Korea. nephrohs@ajou.ac.kr
- Publication Type:Original Article
- Keywords:
IgA nephropathy;
Predicting progression;
Point of no return
- MeSH:
Arterial Pressure;
Creatinine;
Follow-Up Studies;
Glomerulonephritis, IGA*;
Humans;
Immunoglobulin A*;
Kidney Failure, Chronic;
Linear Models;
Retrospective Studies;
Risk Factors;
ROC Curve
- From:Korean Journal of Nephrology
2006;25(1):35-44
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGOUND: The progression rate of IgA nephropathy is known to be variable. We tried to draw an equation that can predict the interval till end stage renal disease (ESRD). METHODS: We retrospectively checked the risk factors of the progression such as demographic, clinical, laboratory, and histologic data by using simple linear regression in eighty eight (M:F=53:35) patients with biopsy-proven IgA nephropathy from Oct 1994 to Aug 2004. By multiple linear regression, a semiquantitative equation estimating the rate of progression was developed. We also evaluated whether there is a "point of no return" that progresses to ESRD which was shown by D'Amico ('93) and Scholl ('99) by receiver operating characteristic (ROC) curve analysis. RESULTS: Mean age and follow-up period were 34.1+/-13.6 years and 55.7+/-31.4 months. Among the risk factors, spot urine protein to creatinine ratio and mean arterial pressure during the follow-up period were significantly associated with the rate of progression (p<0.05). A semiquantitative equation estimating the rate of progression using the two factors was developed as follow. (delta)CCr=2.206-(0.128 x PCR(follow-up))-(0.023 x MAP(follow-up)) (MAPfollow-up:mean arterial pressure; regression coefficient=-0.023, PCRfollow-up:spot urine protein/creatinine; regression coefficient=-0.128). By ROC curve analysis, all patients with maximum serum creatinine over 4.1 mg/ dL during follow-up were found to progress to ESRD. CONCLUSION: We conclude that in Korean IgA nephropathy patients we could predict the rate of decline in renal function for individual patients semiquantitatively and we could confirm the existence of a "point of no return" during the course of IgA nephropathy.
