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Immunoglobulin A nephropathy has variable clinical presentations of asymptomatic hematuria to rapidly progressive glomerulonephritis. It may also present with hypertension and a slow decrease in glomerular filtration rate over months or even years which can easily be attributed to hypertensive target organ damage. Here, a 9-year follow-up of 45-year-old male with a history of hypertension, obesity, and smoking history was discussed. During his follow-up, he had intermittent isomorphic urinary erythrocytes and slow progression in decrement of kidney functions without significant proteinuria. After 3 years of slow progression which was formerly thought be caused by hypertension, smoking, and obesity-related kidney disease, he had a rapid decrease in glomerular filtration rate. Kidney biopsy revealed immunoglobulin A nephropathy with hypertensive nephrosclerosis. Treatment with methylprednisolone improved and slowed his kidney disease progression. We would like to remind clinicians to be aware of slowly progressive immunoglobulin A nephropathy with isomorphic hematuria and without significant proteinuria. The presence of other risk factors such as smoking, hypertension, and obesity should not blur silent increases in serum creatinine levels in order not to delay kidney biopsy as untreated immunoglobulin A nephropathy leads to uncontrolled hypertension, which increases irreversible kidney injury.
Cite this article as: Kaynar RK, Mungan S. Slowly progressive immunoglobulin A nephropathy with isomorphic hematuria and without significant proteinuria: A case report and follow-up for 9 years. Turk J Nephrol. 2023;32(1):94-97.