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Abstract: PO1581

Factors Associated with ESKD in Mexican Patients with IgA Nephropathy: A Single-Centre Retrospective Cohort Study

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Xavier, Daniela, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, ciudad de Mexico, Mexico
  • Ramos De Jesus, Guadalupe, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, ciudad de Mexico, Mexico
  • Garcia-Flores, Octavio Rene, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, ciudad de Mexico, Mexico
  • Moguel, Bernardo, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, ciudad de Mexico, Mexico
Background

IgA nephropathy (IgAN) is the most common primary glomerulonephritis in the world among patients undergoing renal biopsy. To standardize the histological findings, the Oxford Classification (OC) has allowed clarifying kidney lesions that confer potential risk of progression. The aims are describe the factors associated with ESKD and treatment implemented in Mexican patients with IgAN.

Methods

We conducted a single-center, retrospective cohort study in a tertiary hospital in Mexico City, patients with biopsy-proven IgAN and followed up for at least 2 years and examined the relationship between clinical parameters and OC to predict the risk of ESKD after biopsy. We used age and sex adjusted Cox proportional hazards models to study the association of the predictor variables (MEST-C, global glomerulosclerosis and proteinuria > 1g/day) with the incidence of ESKD. The HRs were expressed with 95% confidence intervals (95% CI).

Results

35 patients were included, mean age 37.2±15.2 years, 60% were female, mean eGFR and proteinuria at biopsy were 60.8± 34.6 ml/min/1.73m2 and 3.4± 4.0 g/day respectively. ESKD or eGFR decline by ≥50% as compared to baseline occurred in 10 patients (28.6%) in of follow-up of 2 years. The eGFR at 24 months post-biopsy 59.1± 39.6 ml/min/1.73m2. 18 patients received immunosuppressive treatment and 24 received prednisone.The distribution of MEST-C lesions were: M1-35(100%), E1-20(57.1%), S1-33(94.3%), T1-15(42.9%) and T2-5(7.5%), C1-11(31.4%) and podocytopathic features in 5 (14.3%). Of the MEST-C components, only T2 was significantly associated with ESKD (HR 4.66, 95% CI 0.8 to 27.1). After adjusting for confounding variables global glomerulosclerosis >50% (HR 1.92 [1.02-3.58], p=0.001) and new Oxford classification system (O-grade) grade III (HR 2.79 [0.89-8.58], p=<0.001) were independently associated with ESKD.

Conclusion

There are no reports in Mexico of clinical characteristics and outcomes of IgA nephropathy. This study demonstrates that IgA nephropathy was more common in young adults and women and that the progression to ESKD or the global glomerulosclerosis >50% is similar to the reported in the literature.IFTA >50%, and O-grade III were associated with the development of ESKD in Mexican population.