SAT-007 CLINICAL IMPACT OF CONTINUOUS HEMATURIA REMISSION AFTER TREATMENT AMONG IGA NEPHROPATHY

Abstract

Proteinuria is a well-established risk factor for IgA nephropathy patients, however predictive value of baseline hematuria was denied in nearly all previous studies. Herein, we analyzed the association of continuous hematuria remission with renal outcome among IgA nephropathy patients intensively treated by corticosteroid. We followed the subject of 97 IgA nephropathy patients with a median age of 33 [25-46] at Nagoya University Hospital. Urine sediment examination was regularly recorded during a median follow-up period of 5.3 years. The continuous hematuria remission, defined as continuous urine sediment <5 RBC X hpf, was analyzed in association with the renal outcome of 30% eGFR decline. Baseline characteristics [median and IQR] of all subjects were, proteinuria 1.2 [0.7-2.1] g/day, SCr 0.9 [0.67-1.03] mg/dl, eGFR 74 [58-92], and positive hematuria 71 (73.2%). 71 (73%) of patients were treated by mPSL pulse therapy and 33 (34%) conducted tonsillectomy. 31 patients showed continuous hematuria remission after treatment. The proportion of 30% eGFR decline was observed in 15 (15.5%) patients. In the Kaplan-Meier analysis, the survival rate among patients with continuous hematuria remission after treatment was significantly better (p=0.034). In univariate analysis proteinuria, baseline eGFR, continuous hematuria remission and T-score from the Oxford classification were significantly associated with renal outcome. Whereas, in the multivariate analysis only the continuous hematuria remission was a significant predictive factor for the renal outcome (HR= 0.08, 95%CI 0.01-0.71, p=0.024).Tabled 1Baseline characteristicsAll patients n=97with Continuous hematuria remissionn=31Without continuous hematuria remissionn=66p-valueAge (year)33 [25-46]35 [28-46]33 [25-46]0.601Sex (m/f) %43/5715/1627/390.488BMI (kg/m^2)22.1±3.622.2±3.721.9±3.50.826eGFR (ml/min/1.73 m^2)76±2576±2677±240.429proteinuria (g/day)1.2 [0.7-2.1]1.1 [0.7-1.7]0.9 [0.5-1.7]0.842Renal biopsy %M1 %1923170.485E1 %3626410.149S1 %7684730.229T1+2 %1623120.184C1 %401353<0.001During follow-upPSL+/- %7374740.996RAS-blockade %7677760.858Tonsillectomy %3432350.802 Open table in a new tab Continuous remission of hematuria after treatment could be a valuable predictive factor for renal outcome in IgA nephropathy patients.