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Remission of Proteinuria Improves Prognosis in IgA Nephropathy

2007; American Society of Nephrology; Volume: 18; Issue: 12 Linguagem: Inglês

10.1681/asn.2007050526

1533-3450

Heather N. Reich, SteCombining Acute Accentphan Troyanov, James W. Scholey, Daniel Cattran,

Ion Transport and Channel Regulation

Proteinuria has been shown to be an adverse prognostic factor in IgA nephropathy. The benefit of achieving a partial remission of proteinuria, however, has not been well described. We studied 542 patients with biopsy-proven primary IgA nephropathy in the Toronto Glomerulonephritis Registry and found that glomerular filtration rate (GFR) declined at −0.38 ± 0.61 ml/min per 1.73 m2/mo overall, with 30% of subjects reaching end-stage renal disease. Multivariate analysis revealed that proteinuria during follow-up was the most important predictor of the rate of GFR decline. Among the 171 patients with 3 g/d (n = 121) lost renal function 25-fold faster than those with <1 g/d. Patients who presented with ≥3 g/d who achieved a partial remission (<1 g/d) had a similar course to patients who had ≤1 g/d throughout, and fared far better than patients who never achieved remission. These results underscore the relationship between proteinuria and prognosis in IgA nephropathy and establish the importance of remission.