Which factors are predictors of poor renal outcomes for immunoglobulin A (IgA) nephropathy?

Updated: May 19, 2020
  • Author: Sohail Abdul Salim, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Other predictors of poor renal outcomes include the following:

  • High serum creatinine level (>120 mmol/L) at presentation
  • Hypertension (diastolic >95 mm hg or need for antihypertensive treatment)
  • Proteinuria: Urinary protein excretion 3.5 g/24 hr with 7% renal survival [17]
  • Extensive interstitial fibrosis and tubular atrophy on renal biopsy
  • C4d staining on biopsy

A calculator for estimating the risk of progression to ESRD in patients with IgA nephropathy has been developed by Xie et al, based on a cohort of 619 Chinese patients. [18] It has yet to be validated in other ethnic groups. The calculator uses four variables: glomerular filtration rate, hemoglobin level, serum albumin level, and systolic blood pressure.

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