Survival and the Factors Affecting It in Immunoglobulin A Nephropathy

IgA nephropathy is one of the most widely seen glomerulonephritides. It is one of the major causes of end stage renal disease. The aim of this study was to determine the clinical, biochemical, properties, treatment modalities, renal survival and factors affecting survival of patients with IgA nephropathy followed up in our center.

Seventy-five patients (F:M=20:55, mean age=31.9±10.5) who were biopsied in our center between 1990 and 2003 were recruited into the study. The histopathological properties, arterial blood pressures, biochemical values, urinalysis for hematuria and poteinuria and levels of daily proteinuria determined both at the time of biopsy and during last 3 controls were evaluated. The treatments given were recorded. The differences between treated and not treated patients with respect to each type of the therapy were assesed by using Mann-Whitney-U test. The renal survival was calculated by using Kaplan-Meier and the affecting factors by using Cox regression methods.

The 5- and 10-year renal survivals were calculated as 78% and 60% respectively when the final end-point was assumed to be doubling of serum creatinine with respect to initial value and/or development of ESRD. The patients who had used omega-3 fatty acids had better renal survivals. The factors affecting the renal survival significantly were initial serum creatinine, interstitial fibrosis and glomerulosclerosis, initial diastolic and final systolic blood pressures.

In conclusion some histopathologic findings, biochemical values, arterial blood pressure levels are determined to affect the renal survival. However the natural history of the disease that shows variabilities among individual patients is thought to be one of the major factors affecting the renal survival.