title: A validated model of disease progression in IgA nephropathy.
abstract: BACKGROUND
  IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the general population. There is accumulating evidence that immunosuppressive treatment is efficacious in IgAN. However, it is critical to define appropriate indicators for this therapy especially in the wake of potentially deleterious side effects to immunosuppressives.
  
  
  METHODS
  This study retrospectively reviewed IgAN cases collected since 1981 to identify clinical and/or histological parameters for disease progression; 310 patients with biopsy proven IgAN, diagnosed from January 1981 to March 2004, were included.
  
  
  RESULTS
  We defined a clinical prognostic index (CPI) using multivariate analysis, which incorporated these clinical/ histological parameters. Semiquantitative scores were assigned as follows: 2 points if creatinine (Cr) was >1.4 mg/dL, 1 point if proteinuria was >1 g/24 hr, 1 point if a patient was affected by hypertension, and 1 point if a patient was older than 30 yrs. Dividing our population into two groups (scores 0-2 = low CPI group; scores 3-5 = high CPI group), we demonstrated a significantly different 10-yr renal survival rate; in the low CPI group, renal survival since time of biopsy at 10 yrs was 91.7%; in the high CPI group the renal survival at 10 yrs was 35%. We validated the CPI in an independent sample from Verona (validation group) and demonstrated similar results for the CPI.
  
  
  CONCLUSIONS
  The CPI is convenient to use for defining the risk of disease progression.
authors.affiliation: Division of Nephrology, University of Modena and Reggio Emilia, Italy. Magistroni.Riccardo@unimore.it
authors.forename: Richardo
authors.initials: R
authors.lastname: Magistroni
authors.forename: Luciana
authors.initials: L
authors.lastname: Furci
authors.forename: Marco
authors.initials: M
authors.lastname: Leonelli
authors.forename: Mario
authors.initials: M
authors.lastname: Masellis
authors.forename: Giulia
authors.initials: G
authors.lastname: Ligabue
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lucchi
authors.forename: Antonio
authors.initials: A
authors.lastname: Lupo
authors.forename: Brigida
authors.initials: B
authors.lastname: Brezzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambaro
authors.forename: Luca
authors.initials: L
authors.lastname: Manganelli
authors.forename: Giada
authors.initials: G
authors.lastname: Pedrazzi
authors.forename: Marco
authors.initials: M
authors.lastname: Ricardi
authors.forename: Luisa
authors.initials: L
authors.lastname: Bormioli
authors.forename: Alberto
authors.initials: A
authors.lastname: Albertazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents