IgA nephropathy: multivariate statistical analysis aimed at predicting outcome.
BACKGROUND
Several risk factors of IgA nephropathy (IgAN) have been identified, but their importance in predicting outcome is still controversial.


METHODS
We conducted a retrospective study on 119 patients (pts) with IgAN. All had a follow-up of over five years (mean 134+/-56 months). For each patient we recorded age, 24h proteinuria, hematuria, renal function (RF), arterial hypertension (AH) and histological features. Multivariate analysis was done for predictive purposes (segmentation, using Chi-squared Automatic Interaction Detection-CHAID).


RESULTS
AH at the time of renal biopsy was the principal and independent predicting factor: 30/50 (60%) hypertensive pts had serum creatinine > or =1.5 mg/dL at the end of follow-up compared to 9/69 (13%) pts with normal blood pressure. Age was a further predictive parameter: 21/28 (75%) pts with AH and age over 39 years had reduced RF at the last examination. In this subgroup, 18/19 (95%) with evidence of tubulo-interstitial lesions showed a decline of RF.


CONCLUSIONS
AH and age alone are significant prognostic factors; tubulo-interstitial lesions are an additional pointer to poor outcome in these pts. The algorithm obtained with segmentation analysis may be a guideline for prognosis in single patients with IgA nephropathy.
Fofi
C
C
Department of Clinical Sciences, Chair of Nephrology, La Sapienza University, Rome, Italy.
Pecci
G
G
Galliani
M
M
Comunian
M C
MC
Muda
A O
AO
Pierucci
A
A
Cinotti
G A
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005922:Glomerulonephritis, IGA / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome