A study on the prognostic factors of progressive iga nephropathy

Hamaguchi, N.

A retrospective study was conducted on 142 IgA nephropathy patients composed of 78 males and 64 females in order to determine the possible correlation of the three histological grades of nephropathy (classified into 36 mild cases belonging to Grade I, 59 moderate cases to Grade II, and 47 severe cases to Grade III) to their clinical features, laboratory findings, and immunofluorescence findings. This study demonstrated that the following were the prognostic factors of progressive IgA nephropathy: 1) advanced age and hypertension, 2) moderate to severe fasting proteinuria and more than 1.5 g/day of urinary protein, 3) low erythrocyte count and decreased hemoglobin value, 4) elevated blood sedimentation rate, 5) depressed serum albumin level, elevated serum .alpha.2-globulin level, and increased total cholesterol and triglyceride levels, 6) decreased bleeding time and elevated plasma fibrinogen value, 7) elevated BUN and serum creatinine levels and decreased GFR and 15-min PSP values, 8) elevated serum IgA and .alpha.1-acid glycoprotein levels, decreased Leu 2a, increased Leu 3a, and increaed Leu 3a/Leu 2a, and 9) glomerular deposition of C3 and fibrinogen by immunofluorescence test. It was considered advisable to provide appropriate treatment to cases of progressive IgA nephropathy predicted by the clinical application of the foregoing prognostic factors.