Mesangioproliferative glomerulonephritis: a 30-year prognosis study.
BACKGROUND
Diffuse mesangioproliferative glomerulonephritis (MesP) is the most commonly diagnosed type of glomerulonephritis (GN) in Denmark, with an incidence of 10.8 million per year. In the present study, the 30-year renal survival was estimated.


METHODS
A retrospective cohort investigation of 140 patients with biopsy-proven MesP was performed between the period 1967-2006. Factors influencing renal survival were investigated using Cox regression analysis.


RESULTS
Renal survival at 5, 10, 20 and 30 years was 87, 78, 59 and 50%, respectively. Female survival after 30 years was significantly better than male survival (70 vs. 40%, p = 0.049). Multivariate analysis, adjusted for age, estimated glomerular filtration rate (GFR) and nephrotic syndrome (NS) was performed for each sex individually. An increase in GFR was associated with a hazard risk (HR) of 0.98 (p = 0.02) in women and 0.99 (p = 0.006) in men. Older age was associated with a HR of 1.04 (p = 0.02) in women and 1.03 (p = 0.004) in men. NS had a poorer prognosis in men (HR 2.53, p = 0.01), but not in women (HR 0.54, p = 0.38).


CONCLUSIONS
Increasing age and decreasing GFR were adversely associated with renal death. Renal prognosis was better for women after 30 years, and NS resulted in a poorer prognosis in men. This suggests that disease course and prognosis are different between men and women.
Institute of Public Health, Aarhus University, Aarhus, Denmark ; Department of Internal Medicine, Ribe County Hospital, Esbjerg, University of Copenhagen, Copenhagen, Denmark ; Diagnostic Center, Regionhospital Silkeborg, Silkeborg, Denmark.
Mette
M
Axelsen
Department of Internal Medicine, Ribe County Hospital, Esbjerg, University of Copenhagen, Copenhagen, Denmark.
Robert
R
Smith Pedersen
Department of Nephrology B, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
James Goya
JG
Heaf
Institute of Public Health, Aarhus University, Aarhus, Denmark ; Diagnostic Center, Regionhospital Silkeborg, Silkeborg, Denmark.
Torkell
T
Ellingsen
Cox regression analysis; Primary diffuse mesangioproliferative glomerulonephritis; Prognostic factors; Renal survival