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学科主题: 临床医学
题名:
Natural history of immunoglobulin A nephropathy and predictive factors of prognosis: A long-term follow up of 204 cases in China
作者: Lv, Jicheng1,2; Zhang, Hong1,2; Zhou, Yang1,2; Li, Guangtao1,2; Zou, Wanzhong1,2; Wang, Haiyan1,2
关键词: Chinese ; IgA nephropathy ; renal failure
刊名: NEPHROLOGY
发表日期: 2008-04-01
DOI: 10.1111/j.1440-1797.2007.00898.x
卷: 13, 期:3, 页:242-246
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: IGA NEPHROPATHY ; DISEASE ; RISK
英文摘要:

Aim: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. However, its natural history and risk factors are not well understood. Our aim was to identify the clinical and pathological factors that could predict disease prognosis in Chinese patients.

Methods: We studied 204 biopsy-diagnosed IgAN patients, who were followed for an average of 6.1 years (range, 4-15 years). Chronic kidney disease (CKD) classified according to the Kidney Disease Outcomes Quality Initiative practice guidelines. Renal pathological lesions were graded single-blindedly according to the Haas classification. The glomerular filtration rate was estimated by the Modification of Diet in Renal Disease equation for Chinese subjects.

Results: Patients with CKD were classified as stage 1 (38.10%), stage 2 (35.40%), stage 3 (13.30%), stage 4 (9.90%) and stage 5 (3.30%). During the follow up, 31 patients had progressed to end-stage renal disease. The renal survival rate following biopsy was 85.1% at the fifth year, and 77.1% at the 10th year. Univariate analysis indicated that patients who were male, had hypertension, proteinuria of more than 1 g/day, renal impairment (estimated glomerular filtration rate, <60 mL/min.1.73 m(2)), and a high histological grading were associated with poor prognosis. Multivariate analysis indicated that the relative risk of renal failure for patients was 3.9 (P = 0.000) for patients with renal impairment, 2.8 (P = 0.019) for patients with hypertension, and 2.0 (P = 0.003) for patients with high histological grading.

Conclusion: We described the natural history of IgAN through follow ups of a relatively large cohort of patients. Most patients were biopsied at an early stage; however, the long-term prognosis was still poor. Patients with renal impairment, hypertension and advanced histological involvement had the highest risk for disease progression.

语种: 英语
WOS记录号: WOS:000254578500010
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55540
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China
2.Peking Univ, Inst Nephrol, Peking Univ Hosp 1, Div Renal,Dept Med, Beijing 100034, Peoples R China

Recommended Citation:
Lv, Jicheng,Zhang, Hong,Zhou, Yang,et al. Natural history of immunoglobulin A nephropathy and predictive factors of prognosis: A long-term follow up of 204 cases in China[J]. NEPHROLOGY,2008,13(3):242-246.
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