Abstract
IgA nephropathy is not a one-shot disease, but follows a unique repetitive course from disease onset to progression, remission, and relapse. In order to determine appropriate management strategy for IgA nephropathy, target proteinuria needs to be defined. In two cohort studies examining at time-average proteinuria over the whole follow-up, proteinuria associated with decent renal survival was 1.0 g/day and less than 0.5 g/day. This category of proteinuria is referred to as partial remission. By contrast, a view that clinical remission with complete disappearance of both proteinuria and hematuria at final observation is required for better renal survival is widely common in Japan. However, by strict definition, time-average proteinuria during follow-up and urinary abnormalities at the end of observation period are not predictors of subsequent prognosis. Because of this, the more solid finding of the close association between proteinuria after 1–2 years of intervention and subsequent prognosis is explored to seek target proteinuria in management of IgA nephropathy.
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