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Original Article
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Korean J Med. 2015;88(1):46-53. Published online January 1, 2015.
DOI: https://doi.org/10.3904/kjm.2015.88.1.46
- IgA 신장병의 장기 추적에 따른 임상 경과 및 예후 인자
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백진혁, 김예림, 박하연, 황은아, 한승엽, 박성배
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계명대학교 의과대학 내과학교실
- Clinical Manifestations and Prognostic Factors of IgA Nephropathy with Long-Term Follow-Up
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Jin Hyuk Paek, Yae Rim Kim, Ha Yeon Park, Eun Ah Hwang, Seung Yeup Han, Sung Bae Park
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Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- Corresponding author: Sung Bae Park ,Tel: +82-53-250-7913, Fax: +82-53-253-7976, Email: sbpark@dsmc.or.kr
- Received: March 24, 2014; Revised: May 22, 2014 Accepted: June 5, 2014.
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- Abstract
- Background/Aims
Immunoglobulin A nephropathy (IgAN) is the most common type of primary glomerulonephritis worldwide. Although several studies have identified IgAN prognostic factors in Korea, the follow-up period was insufficient to evaluate the natural history of IgAN. Methods: A total of 471 patients were diagnosed with IgAN after percutaneous renal biopsy between April 1985 and March 2003. Patients with secondary IgAN and patients with a follow-up < 10 years since their diagnosis were excluded. Thus, 184 patients were enrolled. Results: Among the 184 patients, 97 were males (52.7%) and 87 were females (47.3%). The mean age was 33.7 ± 11.5 years, and the mean follow-up period was 181.3 ± 46.3 months. During the follow up, 73 patients (36.9%) had progressed to end-stage renal disease (ESRD). The mean duration to ESRD was 98.1 ± 55.9 months. The overall renal survival rate was 60.3%, the 10-years renal survival rate was 74.3%, and the 20-years renal survival rate was 49.3%. Univariate analyses indicated that hypertension, serum creatinine > 1.3 mg/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, serum albumin < 3.5 g/dL, proteinuria ≥ 1 g/day, and severe renal pathology by the Haas sub-classification were significantly associated with ESRD. When these factors were included in multivariate Cox regression analyses, only severe renal pathology by the Haas sub-classification was an independent prognostic factor for IgAN. Conclusions: Careful follow-up and treatment is recommended, particularly in patients with IgAN and severe renal pathology by the Haas sub-classification.
Keywords :Glomerulonephritis, IgA nephropathy, Prognosis
