Abstract: SA-PO267

Routine Urinalysis Does Not Correlate with Kidney Pathology in IgA Nephropathy after Steroid Therapy

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Yun, Hyaejin, MIRAE ING kidney center, Seoul, Korea (the Republic of)
  • Cho, Byoung-Soo, Mirae Kidney Center, Seoul, Korea (the Republic of)
  • Jung, Sung min, Mirae Kidney Center, Seoul, Korea (the Republic of)
  • Hong, Wang kwang, ByulE plastic surgery, Seoul, Korea (the Republic of)
  • Kim, Daeyoung, n-biotek, Seoul, Korea (the Republic of)
  • Ha, Sung-gyu, MIRAE ING Kidney Center, Seoul, Korea (the Republic of)
  • Ko, Haengil, MIRAE ING Kidney Center, Seoul, Korea (the Republic of)
Background

Routine urinalysis, especially hematuria and proteinuria, has long been used as the most important laboratory tools in the diagnosis of glomerulonephritis and also widely adopted as a screening tool for kidney problems at school screening or health checking program. Recently other newly developed markers for kidney injury, such as cystatin-c, KIM-1, L-FABP, NGAL etc., were developed but not routinely used because lack of accumulated convincing data as yet.

Methods

We performed follow up kidney biopsy who showed normal urinalysis and serum cystatin-c for more than 3 months after steroid therapy to check the kidney status in 25 patients with IgA nephropathy. All 25 patients took longterm steroid therapy more than 6 months. Mean age was 28.1 years old. Mean follow up biopsy interval was 13.3 months. All kidney biopsy were performed at the OPD level without admission. We used ACE-Cut disposable biopsy needle under the ultrasound guide(LOGIQ E9).

Results

All 25cases showed abnormal urinalysis such as persistent hematuria, persistent proteinuria or associated with hematuria and proteinuria at initial kidney biopsy, and showed persistent normal urinalysis findings include hematuria and proteinuria more than 3 months at the time of follow up renal biopsy. Twenty cases showed persistent original diseases although slight to moderate degree pathological improvement. However only 5 cases progressed renal pathologies at the time of follow up biopsy. Among five pathologically progressed cases, 3 cases showed improvement of urinalysis findings and urine protein to creatinine ratio.

Conclusion

Although further studies are needed, anyone who showed segmental or global sclerosis, when associated with moderate to severe tubular atrophy and interstitial fibrosis at initial kidney biopsy, follow up kidney biopsy is mandatory even showed persistent normal urinalysis and lab findings before finishing steroid therapy.