¿Ha mejorado la supervivencia renal en la glomerulonefritis IgA en las últimas tres décadas?

Abstract

Aim: To have the knowledge of the incidence, clinical, analytical and histological presentations, the kidney survival mean and the contribution of treatments to it. Methods: A descriptive, observational and transversal study over 156 patients who were diagnosed of primary IgA glomerulonephritis between 1994 and 2018 in the Nephrology department of Reina Sofía Hospital in Córdoba. Variables were analysed globally and compared between group 1 (G1) 1994-2002, group 2 (G2) 2002-2010 and group 3 (G3) 2010-2018. Results: Annual incidence 8,4 cases/million, 69,2% men, age mean 35,4±15,2 years old, serum creatinine mean 1,7±1,2 mg./dl., proteinuria mean 1,9±2,4 g./24h., macroscopic hematuria 41,4%, arterial hypertension 61,5%, ACEI/IIARA 87,5% and corticosteroids 33,7%. Kidney biopsy, mesangial proliferation 71,1%, sclerosis 49,2%, severe fibrosis 27,1%. The kidney survival at 10 and 20 years was 80,6% and 77,3%, respectively. GROUPS. The annual incidence increased in G3 (9,9 cases/million VS 6,9 cases/million G1), higher age mean (39,4±16,5 years old VS 31,5±14,9 years old G1, p=0,011), lower macroscopic hematuria (27,5% VS 58,8% G1, p=0,021) and worse prognosis histological characteristics, S1 (59,6% VS 25% G1, p=0,005) y F2 (21,7% VS 20% G1, p=0,016). The kidney survival at 8 years was identical in three groups (p=0,16). Conclusion: The incidence of biopsies with IgA nephropathy in Cordoba was increased between 2010 and 2018, with older patients, lower macroscopic hematuria and worse prognosis histological characteristics. Treatments and kidney survival at 8 years have not varied in three groups, making a different therapeutic approach necessary in order to improve the prognosis of the disease.