Predicting the Risk for Dialysis or Death in IgA Nephropathy

被引:308
作者
Berthoux, Francois [1 ,2 ,3 ]
Mohey, Hesham [1 ,2 ,3 ]
Laurent, Blandine [1 ,2 ,3 ]
Mariat, Christophe [1 ,2 ,3 ]
Afiani, Aida [1 ]
Thibaudin, Lise [1 ,2 ,3 ]
机构
[1] Univ N Hosp, Nephrol Dialysis & Renal Transplantat Dept, St Etienne, France
[2] PRES Univ Lyon, GIMAP EA 3064, Res Grp, Lyon, France
[3] Univ St Etienne, St Etienne, France
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2011年 / 22卷 / 04期
关键词
CONTROLLED-TRIAL; NATURAL-HISTORY; OXFORD CLASSIFICATION; PROGNOSTIC-FACTORS; RENAL SURVIVAL; PRIMARY-CARE; PROGRESSION; DISEASE; GLOMERULONEPHRITIS; FRAMINGHAM;
D O I
10.1681/ASN.2010040355
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
For the individual patient with primary IgA nephropathy (IgAN), it remains a challenge to predict long-term outcomes for patients receiving standard treatment. We studied a prospective cohort of 332 patients with biopsy-proven IgAN patients followed over an average of 13 years. We calculated an absolute renal risk (ARR) of dialysis or death by counting the number of risk factors present at diagnosis: hypertension, proteinuria >= 1 g/d, and severe pathologic lesions (global optical score, >= 9). Overall, the ARR score allowed significant risk stratification (P < 0.0001). The cumulative incidence of death or dialysis at 10 and 20 years was 2 and 4%, respectively, for ARR = 0; 2 and 9% for ARR = 1; 7 and 18% for ARR = 2; and 29 and 64% for ARR = 3, in adequately treated patients. When achieved, control of hypertension and reduction of proteinuria reduced the risk for death or dialysis. In conclusion, the absolute renal risk score, determined at diagnosis, associates with risk for dialysis or death.
引用
收藏
页码:752 / 761
页数:10
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