Severity of nephrotic IgA nephropathy according to the Oxford classification

• Published in: International urology and nephrology 2012-08, Vol.44 (4), p.1177-1184
• Main Authors: Moriyama, Takahito, Nakayama, Kayu, Iwasaki, Chihiro, Ochi, Ayami, Tsuruta, Yuki, Itabashi, Mitsuyo, Tsukada, Misao, Takei, Takashi, Uchida, Keiko, Nitta, Kosaku
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biopsy; Female; Glomerular Filtration Rate; Glomerulonephritis, IGA - classification; Glomerulonephritis, IGA - complications; Glomerulonephritis, IGA - diagnosis; Humans; Kidney - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Nephrology – Original Paper; Nephrotic Syndrome - classification; Nephrotic Syndrome - diagnosis; Nephrotic Syndrome - etiology; Retrospective Studies; Severity of Illness Index; Urology; Young Adult
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-011-0109-5

Background IgA nephropathy with nephrotic syndrome (nephrotic IgAN) is a rare form of IgAN. Its prognosis and response to steroid therapy are still controversial because the differential diagnosis between nephrotic IgAN and minimal change nephrotic syndrome with IgA depositions is sometimes confused. Methods In this retrospective cohort analysis, we accurately diagnosed 42 cases of nephrotic IgAN (4.4%) from 954 IgAN patients, according to the Oxford classification. We analyzed the clinical and histological data, prognosis, and response to steroid therapy. Results In nephrotic IgAN, mean estimated glomerular filtration rate (eGFR) was 51.1 ± 24.6 ml/min, proteinuria was 5.71 ± 2.56 g/day, and urinary red blood cells were 51.0 ± 37.8 high power field. Both active and chronic histological lesions were observed. Cumulative renal survival rate was significantly lower in nephrotic IgAN than in non-nephrotic IgAN (the control group consisted of 47 non-nephrotic IgAN patients diagnosed between 1995 and 1996) (log-rank test: P