title: Clinical and histopathologic profile of patients with primary IgA nephropathy seen in a tertiary hospital in India.
abstract: BACKGROUND
  IgA nephropathy (IgAN) is known to have an aggressive course in Asians. There is a paucity of data regarding the Oxford classification pattern of Indian patients with IgAN. This study aims to characterize the clinical and histopathologic profile of these patients.
  
  
  METHODS
  All patients diagnosed to have primary IgAN by kidney biopsy in the nephrology department from July 2009 to July 2014 were included in this study. All kidney biopsies were reviewed and the MEST score was assigned as per the Oxford classification. The clinical features and Oxford classification score of patients were characterized.
  
  
  RESULTS
  Nephrotic range proteinuria (NRP) (65/103, 63.1%) with or without edema was the commonest presentation. 67.0% patients had eGFR ≥ 60 mL/min and 16.5% patients had eGFR < 30 mL/min. Of the 103 patients, 80 (77.7%) had M1, 10 (9.7%) had E1, 45 (43.7%) had S1 and 41 (39.8%) had T1/T2 lesions by the Oxford criteria and 11 (10.7%) patients had crescents. 62 patients had eGFR ≥ 30 mL/min and follow up for at least 6 months (median -17.7 (6-65.1) months) of whom 52(83.9%) had received ACEi/ARBs and 38 (61.3%) had received immunosuppression. 11/62 (17.7%) patients developed renal worsening in this period of which 7 (11.3%) developed end stage kidney disease (ESKD).
  
  
  CONCLUSIONS
  Indian patients with primary IgA nephropathy have a unique profile. They commonly present with nephrotic range proteinuria. A significant proportion of these patients have normal renal function despite heavy proteinuria. Mesangial proliferative lesions are predominant with a paucity of endocapillary proliferation and crescents compared to other Asian populations. Immunosuppressive use is more common in Indian patients.
authors.affiliation: a Department of Nephrology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Soumita
authors.initials: S
authors.lastname: Bagchi
authors.affiliation: b Department of Pathology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Geetika
authors.initials: G
authors.lastname: Singh
authors.affiliation: c Department of Pathology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Rajni
authors.initials: R
authors.lastname: Yadav
authors.affiliation: d Department of Biostatistics , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Mani
authors.initials: M
authors.lastname: Kalaivani
authors.affiliation: e Department of Nephrology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Sandeep
authors.initials: S
authors.lastname: Mahajan
authors.affiliation: f Department of Nephrology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Dipankar
authors.initials: D
authors.lastname: Bhowmik
authors.affiliation: g Department of Pathology , All India Institute of Medical Sciences , New Delhi , India ;
authors.forename: Amit
authors.initials: A
authors.lastname: Dinda
authors.affiliation: h Department of Nephrology , All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Sanjay Kumar
authors.initials: SK
authors.lastname: Agarwal
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007194:India; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use*; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids
keywords: Clinical profile; IgA nephropathy; Oxford classification