title: Prognostic pathologic markers in IgA nephropathy.
abstract: Previous studies have shown that the overall severity of the histologic grade and the extent of glomerular sclerosis are important pathologic markers of prognosis in IgA nephropathy. A previous analysis of the clinical and pathologic parameters in 74 patients at New York University Medical Center revealed that the renal survival (serum creatinine concentration of 2 mg/dL or less) was 100% in patients with mild proteinuria, 87% in those with moderate proteninuria, and 69% in those with heavy proteinuria. The incidence of segmental and global proliferation, glomerular sclerosis, tubulointerstitial damage, and vessel sclerosis increased with levels of proteinuria (P less than 0.01 to 0.05). A comparison of the morphologic parameters in 30 patients with similar initial serum creatinine concentrations (less than or equal to 2 mg/dL) but different outcomes demonstrates a greater incidence and severity of pathologic features, especially glomerular sclerosis in the "nonsurvival" than "survival" groups. Vessel sclerosis as quantitatively measured by a "point-count" technique correlates with the extent of glomerular sclerosis (r = 0.5192; P less than 0.001), suggesting a causal relationship or common basis.
authors.affiliation: Department of Pathology, New York University Medical Center, NY 10016.
authors.forename: G R
authors.initials: GR
authors.lastname: Gallo
authors.forename: R
authors.initials: R
authors.lastname: Katafuchi
authors.forename: K
authors.initials: K
authors.lastname: Neelakantappa
authors.forename: D S
authors.initials: DS
authors.lastname: Baldwin
mesh_terms: D005922:Glomerulonephritis, IGA / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology*; D011379:Prognosis