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Titolo:
Outcome of IgA nephropathy in adults graded by chronic histological lesions
Autore:
To, KF; Choi, PCL; Szeto, CC; Li, PKT; Tang, NLS; Leung, CB; Wang, AYM; Ho, KKL; Wong, TYH; Lui, SF; Lai, FMM;
Indirizzi:
Chinese Univ Hong Kong, Dept Anat & Cellular Pathol, Prince Wales Hosp, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Chinese Univ Hong Kong, Dept Med & Therapeut, Prince Wales Hosp, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China Chinese Univ Hong Kong, Dept Chem Pathol, Prince Wales Hosp, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Shatin Hong Kong Peoples R China Peoples R China
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 3, volume: 35, anno: 2000,
pagine: 392 - 400
SICI:
0272-6386(200003)35:3<392:OOINIA>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGRESSIVE RENAL-DISEASE; PROGNOSTIC FACTORS; GLOMERULONEPHRITIS; EXPRESSION; FEATURES; SYSTEM;
Keywords:
immunoglobulin A (IgA) nephropathy; Berger's disease; histological grading; chronicity; prognosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Lai, FMM Chinese Univ Hong Kong, Dept Anat & Cellular Pathol, Prince WalesHosp, Room 34055, Shatin, Hong Kong, Peoples R China Chinese Univ Hong Kong Room 34055 Shatin Hong Kong Peoples R China
Citazione:
K.F. To et al., "Outcome of IgA nephropathy in adults graded by chronic histological lesions", AM J KIDNEY, 35(3), 2000, pp. 392-400

Abstract

This prognostic study of primary immunoglobulin A (IgA) nephropathy focused on chronic irreversible glomerular sclerosis and interstitial fibrosis, based on the premise that this disease is characterized by a protracted and,for many, progressive course. We used a chronicity-based histological grading system to assess the biopsy specimens of 126 adults with IgA nephropathy over a median follow-up of 10 years. Our grading system included a glomerular grading (GG) of 1 to 3 based on the extent of glomerular sclerosis, a tubulointerstitial grading (TIG) of 1 to 3 based on the degree of tubular loss or interstitial fibrosis, and the evaluation of hyaline arteriolosclerosis (HA). These three histological parameters were correlated with each other and with serum creatinine level, degree of proteinuria, and blood pressure at the time of renal biopsy. Univariate analysis showed that these threehistological and three clinical parameters were significantly correlated with renal survival. By multivariate analysis using the Cox regression model, GG, serum creatinine level, and degree of proteinuria represented independent prognostic factors of renal survival. For a subset of patients at a relatively early stage of disease with a serum creatinine level less than 130mu mol/L at the time of biopsy, all three histological features and degreeof proteinuria were significantly correlated with renal survival, and GG was the only independent prognostic factor for renal outcome. This study shows that glomerular sclerosis represents the most important prognostic factor in adult patients with primary IgA nephropathy and has a strong predictive value, Our chronicity-based histological grading system not only correlates well with the natural history of IgA nephropathy but is also reproducible and relatively simple to apply. (C) 2000 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 16:10:26