Prognostic factors in immunoglobulin-A nephropathy.

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dc.contributor.authorMuthukumar, Ten_US
dc.contributor.authorFernando, M Een_US
dc.contributor.authorJayakumar, Men_US
dc.date.accessioned2002-11-14en_US
dc.date.accessioned2009-05-31T02:02:16Z
dc.date.available2002-11-14en_US
dc.date.available2009-05-31T02:02:16Z
dc.date.issued2002-11-14en_US
dc.description.abstractAIM: To study the course, identify prognostic factors and a model predictive for development of end stage renal failure (ESRF) in adults with immunoglobulin-A nephropathy (IgA-N). DESIGN: Retrospective cohort. SETTING: Madras Medical College and Government General Hospital, Chennai, Tamil Nadu. PARTICIPANTS: Ninety eight adult patients with diagnosis of primary IgA nephropathy. RESULTS: Out of 98 patient 64 (65.3%) were men. Mean age of presentation was 25.7 years. The predominant renal lesions included nephrotic syndrome in 25 (25.5%), rapidly progressive renal failure and accelerated malignant hypertension in 21 (21.4%) each, chronic renal failure in 13 (13.3%), hypertension in nine (9.2%) haematuria in five (5.1%) and acute renal failure in four (4.1%). Sixty (61%) had renal failure at diagnosis. Age > 25 years, glomerular histology of Hass subclass V and interstitial fibrosis were significant factors. Forty (48.2%) (IR) patients developed ESRF during follow up. Serum creatinine > 5 mg/dl (hazard ratio: 5.37, 95% confidence interval CI 2.49-11.58) Hass-V (3.74, 1.60-8.76), crescents (4.08, 1.52-10.94) and IF (6.15, 2.0-19.0) were associated with disease progression in the multivariate analysis. Five years renal survival (CI) was 38.5% (24.6%-52.3%). Among those with no risk factor, 95% had not reached ESRF by 42 months. The median ESRF-free survival with one, two and three or four risk factors was 65, 16 and four months, respectively. CONCLUSIONS: Serum creatinine > 5 mg/dl, crescents: Hass-V histology and interstitial fibrosis predict the progression to ESRF. Renal biopsies should include a detailed assessment of the tubulointerstitium.en_US
dc.description.affiliationDepartment of Nephrology, Government General Hospital, Chennai, Tamil Nadu.en_US
dc.identifier.citationMuthukumar T, Fernando ME, Jayakumar M. Prognostic factors in immunoglobulin-A nephropathy. Journal of the Association of Physicians of India. 2002 Nov; 50(): 1354-9en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/92693
dc.language.isoengen_US
dc.source.urihttps://www.japi.orgen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshDisease Progressionen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlomerulonephritis, IGA --complicationsen_US
dc.subject.meshHumansen_US
dc.subject.meshIndia --epidemiologyen_US
dc.subject.meshKidney Failure, Chronic --epidemiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProteinuria --etiologyen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSurvival Analysisen_US
dc.titlePrognostic factors in immunoglobulin-A nephropathy.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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