Predicting the risk for dialysis or death in IgA nephropathy.
For the individual patient with primary IgA nephropathy (IgAN), it remains a challenge to predict long-term outcomes for patients receiving standard treatment. We studied a prospective cohort of 332 patients with biopsy-proven IgAN patients followed over an average of 13 years. We calculated an absolute renal risk (ARR) of dialysis or death by counting the number of risk factors present at diagnosis: hypertension, proteinuria ≥1 g/d, and severe pathologic lesions (global optical score, ≥8). Overall, the ARR score allowed significant risk stratification (P < 0.0001). The cumulative incidence of death or dialysis at 10 and 20 years was 2 and 4%, respectively, for ARR=0; 2 and 9% for ARR=1; 7 and 18% for ARR=2; and 29 and 64% for ARR=3, in adequately treated patients. When achieved, control of hypertension and reduction of proteinuria reduced the risk for death or dialysis. In conclusion, the absolute renal risk score, determined at diagnosis, associates with risk for dialysis or death.
Nephrology, Dialysis, and Renal Transplantation Department, University North Hospital, 42055 Saint-Étienne Cedex 2, France. francois.berthoux@chu-st-etienne.fr
François
F
Berthoux
Hesham
H
Mohey
Blandine
B
Laurent
Christophe
C
Mariat
Aida
A
Afiani
Lise
L
Thibaudin
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006973:Hypertension / Q000150:complications; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011507:Proteinuria / Q000150:complications; D012044:Regression Analysis; D006435:Renal Dialysis; D012307:Risk Factors
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