Abstract
BackgroundPrimary IgA nephropathy (IgAN) has variable distribution and clinicopathological spectrum throughout the world. We report the incidence, demographic, and clinicopathological profile of primary IgAN from a tertiary care center in Northern India.MethodsThis is a single-center, prospective, observational study conducted at Sheri- Kashmir Institute of Medical Sciences, J&K, India, from January 2015 to December 2018. The study was approved by the hospital ethical committee.ResultsA total of 106 patients were included in this study, accounting for 19% (106/558) of all native kidney biopsies done during the period from January 2015 till December 2018. Males and females accounted for 60.4% (64/106) and 39.6% (42/106), respectively, with a ratio of 1.5:1. The mean age was 31.37±11.60 years. Edema and hypertension were the most common presenting symptoms and signs, seen in 69 (65.1%) and 72 (67.9%) patients, respectively. The baseline 24-h urine protein excretion was 2.32 ±1.34 g, Nephrotic range proteinuria (≥3.5g/day) was seen in 23/106 (21.7%). Average serum creatinine was 1.6±0.80 mg/dl and estimated glomerular filtration rate using CKD-EPI was <60 ml/min/1.73 m2 in 48.1% of patients (51/106). In patients with < 1 g proteinuria, 36.8% had E1, 78.9% had S1, 36.8% had T1, and 42.1% had T2 lesions.ConclusionsIgAN is common in North India and has a more severe histopathological presentation, characterized by extensive sclerosis and tubulointerstitial fibrosis. Renal dysfunction and nephrotic range proteinuria are common. Hypertension, low eGFR, and proteinuria correlate with the presence of segmental scarring, endocapillary hypercellularity, and IFTA. Screening of asymptomatic individuals might help in early diagnosis and long-term preservation of renal function.
Highlights
First described by Berger and Hinglais in 1968, IgA nephropathy is the most prevalent pattern of glomerular diseases in most countries where renal biopsy is widely used as an investigative tool
Estimated glomerular filtration rate (CKD-EPI eGFR) less than 60 ml/min/1.73m2 was seen in 48.1% (51/106)
mean arterial pressure (MAP) and mean proteinuria were higher and mean eGFR was lower in patients with S1 compared to S0, p value
Summary
First described by Berger and Hinglais in 1968, IgA nephropathy is the most prevalent pattern of glomerular diseases in most countries where renal biopsy is widely used as an investigative tool. IgAN is an immune-complex mediated disease defined by the presence of either. Bhat et al The Egyptian Journal of Internal Medicine (2022) 34:17 these differences in epidemiology reflect differences in health care provision or are secondary to fundamental differences in the pathogenesis of IgAN. We report the incidence, epidemiological, clinical, biochemical, and histopathological characteristics of our IgA cohort from a tertiary care center in Northern India. Primary IgA nephropathy (IgAN) has variable distribution and clinicopathological spectrum throughout the world. Demographic, and clinicopathological profile of primary IgAN from a tertiary care center in Northern India
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