Korean J Nephrol.
1999 Jan;18(1):63-72.
Clinicopathologic Correlation in IgA Nephropathy with Haas' Subclassification
- Affiliations
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- 1Institute of Renal Disease, Department of Internal Medicine, Korea University, College of Medicine, Seoul, Korea.
- 2Depatrment of Pathology, Korea University, College of Medicine, Seoul, Korea.
Abstract
OBJECTIVES
IgA nephropathy is a common type of primary glomerulonephritis and may present with a wide variety of histologic patterns on renal biopsy. IgA nephropathy may progress to end stage renal disease. But it is difficult to predict the prognosis of IgA nephropathy.
METHODS
In an attempt to identify prognostic indicators in this disease, the clinical data from 158 patients with IgA nephropathy were analyzed and compared to the pathologic subclassification proposed by Haas.
RESULTS
1)The mean age of 158 patients with IgA nephropathy was 31.5 yrs(M:F=1:1.04) and there were 17 patients in subclass I, 5 patients in subclass II, 80 patients in subclass III, 34 patients in subclass IV, 22 patients in subclass V. 2)The significant correlation between renal survival rate and histologic subclass in 114 patients who were followed-up for more than 12 months was showed in order of I, II>III, IV>V. 3)Active crescents were a significant negative prognostic indicator in renal survival in subclass III, but not in subclass IV. 4) The presence of immune complex deposits in the glomerular capillary loops in addition to the deposits in mesangial areas was associated with poor prognosis in progression to end stage renal disease of IgA nephropathy 5)With a respect to clinical presentation, hypertension, serum creatinine of>=1.5mg/dL, and proteinuria of>=2.0g/day were significant negative prognostic indicators for renal survival but the presense of gross hematuria was not associated with increased renal survival rate by an univariate analysis.
CONCLUSION
These results suggest that histologic subclassification proposed by Haas may be a useful prognostic indicator for the clinical outcome of IgA nephropathy, as well as the amount of proteinuria, serum creatinine level and hypertension at the time of initial renal biopsy
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