Abstract: TH-PO1024
Spontaneous Remission in Asian Patients with IgA Nephropathy Treated with Conservative Therapy
Session Information
- Glomerular Diseases: Minimal Change Disease, FSGS, IgAN
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1203 Glomerular Diseases: Clinical, Outcomes, and Trials
Authors
- Ichikawa, Daisuke, St Marianna University of Medical School, Yokohama City, KANAGAWA, Japan
- Watanabe, Shiika, St. Marianna University Hospital, Kawasaki Citiy, Japan
- Suzuki, Tomo, Kameda Medical Center, Kamogawa, Chiba, Japan
- Shibagaki, Yugo, St Marianna University Hospital, Kawasaki, Japan
Background
There are few studies describing IgA nephropathy (IgAN) patients with persistent microscopic hematuria with or without minimal proteinuria. However, spontaneous remissions of hematuria and proteinuria were uncommon.
Methods
62 adult patients with IgAN who received conservative treatment at least 5years were investigated. We investigated remission rate of hematuria and proteinuria and assessed the period and the decline of renal function. Remission of proteinuria and hematuria were defined as consecutive three times of proteinuria <0.3 g/gCr and urine red blood cells <5 /HPF throughout an observation period of at least 6 months respectively.
Results
38 (61.3%) patients had remission of hematuria, 24 (38.7%) patients had remission of proteinuria, and 19 (30.6%) patients had both remissions. The group with proteinuria <1.0 g/gCr group, the remission rate was 64.2%. The group with proteinuria <0.5 g/gCr group had a higher remission rate than the group with proteinuria ≧0.5 g/gCr group at the time of renal biopsy. The median time to remission of hematuria was 2.8 years (IQR 1.6-4.2), and that of proteinuria was 2.6 years (IQR 1.7-3.4). Patients who showed renal function decline (30% decline of eGFR from baseline) were significantly older, had significantly lower eGFR and higher proteinuria at the time of renal biopsy. Only two patients with normal renal function and normal range of proteinuria at diagnosis showed 30% eGFR decline. The two patients had persistently proteinuria >0.5 g/gCr after five years.
Conclusion
Relatively high rate of spontaneous remission were shown. In the proteinuria <0.5 g/gCr group, there is high rate of remission of hematuria and proteinuria and renal function was preserved. In the case of proteinuria <1.0 g/gCr, it may be possible to observe over three years with conservative therapy.