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Abstract: PO1589

Remission of Hematuria Is Associated with Favorable Prognosis in IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Lee, Kyung Ho, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Oh, Young seung, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Park, Moo Yong, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Choi, Soo Jeong, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Kim, Jin kuk, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Hwang, Seung Duk, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
  • Yu, Byung chul, Soonchunhyang University Hospital Bucheon, Bucheon, Gyeonggi-do, Korea (the Republic of)
Background

Recent studies have shown that remission of hematuria is associated with favorable clinical outcomes in patients with immunoglobulin A nephropathy (IgAN). The current study was conducted to compare the long-term clinical outcomes between patients with remission of hematuria and those with persistent hematuria using the stricter but intuitive definition of "remission of hematuria" than that used in previous studies.

Methods

This retrospective, multicenter, observational study was conducted using a cohort of patients diagnosed with IgAN through kidney biopsy at three tertiary hospitals. A total of 403 patients who had been followed up for more than 3 years and who underwent regular check-ups at intervals of at least 6 months were enrolled. Hematuria remission was defined as the presence of hematuria for at least 3 months after biopsy for diagnosis but with no RBC per high-power field observed in the urine under the microscope for at least 2 years thereafter.

Results

The mean annual rate of eGFR decline was lower in the remission of hematuria group than in the persistent hematuria group (-1.51 ± 2.86 vs. -2.60 ± 3.18 mL/min/1.73 m2/year, p = 0.002). In the remission of hematuria group, the mean annual rate of eGFR decline decreased after hematuria disappearance (from -1.28 ± 7.06 to 0.09 ± 0.29 mL/min/1.73 m2/year, p = 0.016). Multivariable analysis revealed remission of hematuria as an independent predictor of a 50% reduction in kidney function (hazard ratio, 0.55; 95% CI, 0.33 to 0.99). Renal survival, defined as a 50% reduction in kidney function, was better in the remission of hematuria group than in the persistent hematuria group (p = 0.030). However, free of ESRD was not significantly different between the two groups (p = 0.079).

Conclusion

In this study, which used a more rigorous but intuitive definition of hematuria remission than that used in previous studies, patients with remission of hematuria showed favorable kidney prognosis. This new definition for remission of hematuria could be used as a prognostic marker in actual clinical practice.

Comparison of renal outcomes between the two groups
VariableRemission of hematuria (n=100)Persistent hematuria (n=303)p-value
Mean annual rate of eGFR decline (mL/min/1.73 m2/year)-1.51 ± 2.86-2.60 ± 3.180.002
50% Reduction in kidney function, no. (%)17 (17.0)62 (20.5)0.45
ESRD, no. (%)10 (10.0)37 (12.2)0.559