Prospective study on renal outcome of IgA nephropathy superimposed on diabetic glomerulosclerosis in type 2 diabetic patients

Nephrol Dial Transplant. 2001 Jun;16(6):1183-8. doi: 10.1093/ndt/16.6.1183.

Abstract

Background and methods: In order to examine the clinical outcome of IgA nephropathy (IgAN) superimposed on diabetic glomerulosclerosis in type 2 patients we studied 36 Chinese patients (26 men, 10 women), who were recruited for renal biopsy when they had proteinuria of more than 1 g/day. Twenty-seven had isolated diabetic glomerulosclerosis and nine had IgAN superimposed on diabetic glomerulosclerosis (combined). Renal function was assessed by serial serum creatinine, 24-h urine protein and creatinine measurements. Patient survival rate, incidence of end-stage renal disease (ESRD), blood pressure, and glycaemic control status were determined.

Results: The age at the time of renal biopsy was younger for the combined group when compared with the diabetic glomerulosclerosis group (44+/-3.6 vs 58+/-2.1 years, P=0.006). The duration of diabetes was, however, similar for the two groups (8.0+/-2.3 vs 6.7+/-1.2 years, P=NS). After a mean follow-up of 31.6+/-15.3 months, 15 patients (one in the combined group and 14 in the diabetic glomerulosclerosis group) developed ESRD. Nine patients (all in the diabetic glomerulosclerosis group) died during follow-up. With similar glycaemic and blood pressure control, the two groups had comparable rate of decline of creatinine clearance (CrCl) (-0.73+/-0.26 vs -0.73+/- 0.18 ml/min/1.73 m(2)/month, P=NS), final serum creatinine (363+/-134 vs 426+/-52 micromol/l, P=NS) and proteinuria levels (4.3+/-0.9 vs 4.4+/-0.6 g/day, P=NS), as well as CrCl (44.1+/-19.0 vs 33.4+/-6.9 ml/min/ 1.73 m(2), P=NS).

Conclusion: It is concluded that the superimposed IgAN does not significantly alter the medium-term clinical outcome of patients with diabetic glomerulosclerosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Asian Continental Ancestry Group
  • Biopsy
  • Blood Glucose / metabolism
  • Blood Pressure
  • Creatinine / metabolism
  • Diabetes Mellitus, Type 2 / mortality
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / mortality
  • Diabetic Nephropathies / physiopathology*
  • Female
  • Follow-Up Studies
  • Glomerulonephritis, IGA / complications
  • Glomerulonephritis, IGA / mortality
  • Glomerulonephritis, IGA / physiopathology*
  • Hong Kong
  • Humans
  • Immunoglobulin A / blood
  • Kidney / pathology*
  • Kidney Failure, Chronic / epidemiology
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Proteinuria
  • Survival Rate
  • Time Factors

Substances

  • Blood Glucose
  • Immunoglobulin A
  • Creatinine