New Approach Predicts IgA Nephropathy Outcomes

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French researchers have developed a method for predicting the risk of death or the need for dialysis among patients with IgA nephropathy (IgAN), according to a recent report.

In a prospective study of 332 patients with biopsy-proven IgAN followed over an average of 13 years, the investigators, led by François Berthoux, MD, of Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France, calculated an absolute renal risk (ARR) of death and the need for dialysis by counting the number of risk factors present at IgAN diagnosis.

These risk factors included hypertension (blood pressure of 140/90 mm Hg), proteinuria of 1 g/day or greater, and severe pathologic lesions (global optical score of 8 or higher). The ARR score was the number of these risk factors present at diagnosis. Thus, patients with all three risk factors would have a score of 3 and those without any risk factors would have a score of 0.

The ARR score overall enabled significant risk stratification, the researchers stated. The cumulative incidence of death or need for dialysis at 10 and 20 years was 2% and 4%, respectively, for patients with an ARR score of 0, 2% and 9% for those with a score of 1, 7% and 18% for subjects with a score of 2, and 29% and 64% for patients with a score of 3, the authors reported online in the Journal of the American Society of Nephrology.

In addition, when achieved, control of hypertension and reduction of proteinuria decreased the risk of death or need for dialysis, the investigators noted.

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