Predicting progression in IgA nephropathy
Predicting progression in IgA nephropathy
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DOI：
10.1053/ajkd.2001.27689
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发表时间：
2001-10-01
影响因子：
13.2
通讯作者：
Cattran, DC
中科院分区：
文献类型：
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作者：
Bartosik, LP;Lajoie, G;Cattran, DC
免疫球蛋白A（伊加）肾病是最常见的原发性肾小球肾炎发展为终末期肾病的类型之一。其多变且往往漫长的自然历史使其难以预测结果。我们研究了298例经活检证实的伊加肾病患者的肾功能下降率（基于肌酐清除率随时间的斜率）与人口统计学、临床、实验室和组织学数据的相关性，平均随访时间为70个月。采用单变量分析，基线时尿蛋白排泄量和Lee病理分级，以及随访期间的平均动脉压（MAP）和尿蛋白排泄量与肾功能恶化率相关。其中，只有MAP和尿蛋白排泄量在随访期间被确定为独立因素的多元线性回归分析。在第二年和第三年随访期间，使用这两个参数达到了最佳预测准确性和最短观察时间的组合。一个半定量的方法估计的进展速度，通过使用这些因素的开发。这些结果表明，MAP和蛋白尿严重程度随时间的推移是伊加肾病最重要的预后指标。显示了该算法在患者管理中的潜在相关性。(C)2001年由国家肾脏基金会，公司。
Immunoglobulin A (IgA) nephropathy is one of the most common primary types of glomerulonephritis to progress to end-stage renal disease. Its variable and often long natural history makes it difficult to predict outcome. We investigated the association of the rate of renal function decline based on the slope of creatinine clearance over time with demographic, clinical, laboratory, and histological data from 298 patients with biopsy-proven IgA nephropathy with a mean follow-up of 70 months. Using univariate analysis, urinary protein excretion at baseline and Lee pathological grading, as well as mean arterial pressure (MAP) and urinary protein excretion during follow-up, were associated with the rate of deterioration in renal function. Of these, only MAP and urinary protein excretion during follow-up were identified as independent factors by multiple linear regression analysis. The combination of best accuracy of prediction and shortest observation time using these two parameters was reached between the second and third years of follow-up. A semiquantitative method of estimating the rate of progression by using these factors was developed. These results indicate that MAP and severity of proteinuria over time are the most important prognostic indicators of IgA nephropathy. The potential relevance of the algorithm In patient management is shown. (C) 2001 by the National Kidney Foundation, Inc.