The "point of no return" and the rate of progression in the natural history of IgA nephritis

Citation
U. Scholl et al., The "point of no return" and the rate of progression in the natural history of IgA nephritis, CLIN NEPHR, 52(5), 1999, pp. 285-292
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Urology & Nephrology","da verificare
Journal title
CLINICAL NEPHROLOGY
ISSN journal
0301-0430 → ACNP
Volume
52
Issue
5
Year of publication
1999
Pages
285 - 292
Database
ISI
SICI code
0301-0430(199911)52:5<285:T"ONRA>2.0.ZU;2-#
Abstract
Background: Based on the observation of 7 patients with chronic IgA nephrit is and on a course to end-stage renal failure after several years, D'Amico et al, [1993] reported on a "point of no return" at 2.5 to 3 mg/dl serum cr eatinine. After exceeding this limit all 7 patients exhibited an irreversib le progressive renal failure. Patients and methods: Therefore, 115 patients with IgA nephritis from the "German Glomerulonephritis Therapy Study" were examined in order to look for the existence of such a "point of no return" . Results: Three different courses could be distinguished: a stable chronic course with constantly normal or only minor elevated serum creatinine last ing for years (91 patients), a progressive course with continuously increas ing serum creatinine (22 patients), and a rare (only 2 patients) early acut e course with a short-term increase of serum creatinine followed by a rapid return to the normal range. After exceeding 3 mg/dl serum creatinine no re missions were observed in the progessive cases. Sixteen patients showed a r apid, continuously progressive course until end-stage renal failure with ex actly the same progression as the 7 patients of D'Amico et al. Six patients of the 22 progressors were not observed long enough. The serum creatinine level doubled on average from 3 to 6 mg/dl within 10 months. Conclusion: Ou r study confirmed the existence of a "point of no return" at 3 mg/dl (265 m u mol/l) during the natural course of chronic IgA nephritis.