Clinical course of Immunoglobulin A nephropathy with crescents in a multi-ethnic Southeast Asian cohort.
Nephrology (Carlton)
; 25(9): 708-713, 2020 Sep.
Article
en En
| MEDLINE
| ID: mdl-32400945
ABSTRACT
AIM:
Clinical presentation and course of Immunoglobulin A nephropathy vary by ethnicity and geography and significance of extracapillary proliferation or crescents (IgAN-C) in Southeast Asia is not well described. We aimed to describe the clinical course of IgAN-C in Singapore.METHODS:
Retrospective cohort study of adult biopsy-proven IgAN diagnosed between February 2011 and October 2016 in 2 hospital-based nephrology units. Outcome was chronic kidney disease (CKD) progression, defined as reduction in eGFR ≥50% or end stage renal failure (ESRF).RESULTS:
One hundred and forty-five patients were studied. Among individuals with IgAN-C (n = 44, 30%), 38 patients had cellular or fibrocellular crescents in 1 to 25% of the glomeruli and 6 had crescents in >25%. Median eGFR was 54 (33, 83) mL/min/1.73 m2 . Compared to IgAN without crescents, IgAN-C had greater proteinuria (median 2.9 [1.4, 5.4] g/g vs 1.9 [1.1, 3.6] g/g, P = .03) and more had endocapillary hypercellularity (96% vs 39%, P < .001). IgAN-C were also more likely to receive immunosuppressants (66% vs 43%, P = .01) such as prednisolone (63% vs 38%, P = .006) and cyclophosphamide (12% vs 2%, P = .03). Median follow up was 27 (12, 46) months. IgAN-C were more likely to achieve proteinuria reduction ≥50% at 6 months (66% vs 44%, P = .03). CKD progression within 12 months was not different among those with and without crescents (13% vs 10% respectively, P = .73). However, immunosuppressant treatment of IgAN-C was associated with reduced ESRF (0 vs 20%, P = .03).CONCLUSION:
Immunosuppressants may attenuate the risk of ESRF in IgAN-C.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Proteinuria
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Glomerulonefritis por IGA
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Fallo Renal Crónico
/
Glomérulos Renales
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
País como asunto:
Asia
Idioma:
En
Año:
2020
Tipo del documento:
Article