Spontaneous remission of nephrotic syndrome in patients with IgA nephropathy.
BACKGROUND
IgA nephropathy (IgAN) can be complicated by nephrotic syndrome. Because the spontaneous resolution of heavy proteinuria is rare, corticosteroid therapy should be considered in such cases, particularly when IgAN is combined with minimal-change disease. Here, we report our experience of spontaneous remission of nephrotic syndrome in patients with IgAN and the long-term outcomes of these patients.


METHODS
Two hundred and thirty-three patients with biopsy-proven IgAN were enrolled between January 2001 and March 2009. Demographic, clinical and laboratory data were collected retrospectively based on medical records. In addition, pathologic findings were reviewed for glomerular and tubulointerstitial lesions. Outcome data for complete or partial remission, spontaneous remission, relapse, deterioration of renal function, and end-stage renal disease were recorded.


RESULTS
Twenty-four patients (10.3%) presented nephrotic syndrome. Among them, five patients underwent spontaneous remission within 6 months after the presentation of nephrotic syndrome. Interestingly, spontaneous remission occurred even in two patients who had elevated serum creatinine levels and advanced renal damage. During follow-up, neither recurrence nor relapse occurred, and no patients showed progressive deterioration of kidney function. Conclusions. This study suggests that spontaneous remission of nephrotic syndrome may occur in any stage of IgAN and carries a favourable long-term outcome without relapse. Given the possibility of under-reported cases, large-scale studies are required, and careful attention should be paid to such complicated cases.
Han
Seung Hyeok
SH
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Kang
Ea Wha
EW
Park
Jeong Kyung
JK
Kie
Jeong Hae
JH
Han
Dae Suk
DS
Kang
Shin-Wook
SW
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000473:pathology; D006801:Humans; D007676:Kidney Failure, Chronic; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology* / Q000473:pathology; D011507:Proteinuria; D012075:Remission, Spontaneous; D016896:Treatment Outcome; D055815:Young Adult