title: Long-term survival of patients with IgA nephropathy after dialysis therapy.
abstract: OBJECTIVE
  How dialysis affects the survival of patients with biopsy-proven IgA nephropathy (IgAN) is not fully understood. The present long-term cohort study quantifies the survival rates and incidence of cardio-cerebrovascular diseases (CCVDs) among such patients in Japan.
  
  
  METHODS
  Fifty-two of 433 patients with IgAN who had reached end-stage kidney disease underwent renal replacement therapy (RRT) between 1981 and 2010. The overall survival rate and incidence of CCVDs in these patients were evaluated during follow-up for 11.3 ± 6.4 years.
  
  
  RESULTS
  The mean age at starting RRT was 42.8 ± 13.3 years. Only seven patients died during follow-up (mortality rate, 1.2/100 person-years) and Kaplan-Meier analysis revealed favorable survival rates of 93.3% and 65.1% at 10 and 20 years, respectively, compared with that of patients with glomerulonephritis in the registry of the Japanese Society for Dialysis Therapy who required RRT. Malignancy and CCVDs were causes of death at 13.6 ± 4.8 and 3.9 ± 1.3 years, respectively, after starting RRT. Fatal and non-fatal CCVDs developed in 15 (incidence, 2.7/100 person-years) patients and acute coronary syndrome and cerebral hemorrhage developed relatively soon after starting RRT. Cox proportional hazards models revealed that age at the time of starting RRT was a significant factor affecting the onset of CCVDs. Meanwhile, a history of having had corticosteroid as an initial treatment did not affect the onset of events.
  
  
  CONCLUSIONS
  Although the survival of patients with IgAN is favorable after dialysis, the onset of CCVDs during the early phase of dialysis should be carefully monitored.
authors.affiliation: First Department of Internal Medicine, University of Miyazaki Hospital, Miyazaki, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Komatsu
authors.forename: Masao
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Hideto
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Fukuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwakiri
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Toida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sato
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitamura
authors.forename: Shouichi
authors.initials: S
authors.lastname: Fujimoto
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012042:Registries; D006435:Renal Dialysis / Q000401:mortality* / Q000639:trends*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult