IGA NEPHROPATHY - CORRELATION OF CLINICAL AND HISTOLOGIC FEATURES

Abstract

Clinical and histologic features of 81 patients with IgA nephropathy were analyzed. Azotemia was present in 32% of the patients, proteinuria was present in 88%, and gross or microscopic hematuria was present in all of the patients tested. The median age of histologic diagnosis was 27 yr. The median age at onset of clinical signs was 20 yr. No increased incidence in any HLA-A or -B antigen within the patient population over the control population was seen. All patients had glomerular mesangial IgA deposition (by definition) greater than or equal to IgG or IgM. Histologic changes were quantitated and ranged from normal to necrotizing and/or crescentic glomerulonephritis. Many patients (48%) had mild or moderate generalized glomerular hypercellularity. Nonparametric statistical analysis showed strong correlations among patient age at histologic diagnosis, creatinine, proteinuria, global glomerular sclerosis, and interstital fibrosis. Apparently, IgA nephropathy is an indolent disease generally beginning in childhood. It is a cause of renal insufficiency in a significant number of patients. Most cases of IgA nephropathy in the USA may be best considered idiopathic but hereditary and secondary forms may also exist.