IgA 신증의 예후인자 = Prognostic Factors in Idiopathic IgA Nephropathy

다국어 초록 (Multilingual Abstract)

Objectives: Idiopathic IgA nephropathy is the most frequent type of primary glomerulonephritis in the world. IgA nephropathy was initially considered a benign disease with a favorable prognosis. As data from long-term follow-up studies became available, progression of the disease to renal failure in 20~40% of adult patients was recognized. Many recent studies have demonstrated that some clinical and histologic features can be of assistance for prediction of the clinical course in individual patients. However, with a few exceptions, the numbers of patients studied were two small to draw firm conclusions. Method: To clarify the risk factors or prognostic indices for chronic renal failure (CRF) in idiopathic IgA nephropathy, we performed a dual study on 104 patients using bath standard univariate and multivariate analyses. Results: During a mean follow-up of 24 months, 23% of the patients (24/104) had gone into CRF. The univariate comparison of patients with CRF versus patients without CRF showed multiple risk factors; older age, higher serum creatinine level at biopsy, HBsAg positivity, no history of gross hematuria, arterial hypertension, nephrotic range proteinuria, advanced pathologic grade by Kurt Lee S-M classification and extension of IgA deposits to the peripheral capillary loops. On multivariate analysis, however, only 3 factors; higher level of serum creatinine at biopsy, advanced pathologic grade by Kurt Lee S-M classification and extension of IgA deposits to the peripheral capillary loop; proved to be independent prognostic indicators. Conclusions: Our data confirm the greater usefulness of multivariate over univariate analyses in finding risk factors for CRF in IgA nephropathy. However, it is necessary for study with larger number of patients, more prolonged duration of follow-up and a prospective manner.