Proteinuria as a Surrogate Outcome in IgA Nephropathy. Ron Hogg MD Scott & White Medical Center Temple, Texas. Goals of Presentation. Overview of condition Observational studies Relationship between proteinuria and renal impairment in patients with IgA nephropathy
Ron Hogg MD
Scott & White Medical Center
1. Predicting Progression in IgA nephropathy.
Bartosik et al. Am J Kidney Dis. 2001
2. Early prediction of IgAN progression: Proteinuria and AOPP are strong prognostic markers.
Descamps-Latcha etal. Kidney Int. 2004
1. Univariate Cox regression analysis showed age, proteinuria, hypertension, ACEi, CCr and AOPP levels to be significantly associated with renal outcome
HR (95% CI) = 16.41 (3.97-67.84, p=0.00001)
2. Multivariate analysis confirmed UPEX to be independent predictor of renal outcome
a. With CCr included: HR = 7.78 (1.81-33.4, p=0.006)
b. With CCr excluded: HR = 23.7 (5.35-104.8, p=0.0001)
3. Angiotensin II inhibitors were protective
HR = 0.19 (0.09-0.44, p=0.001)
Praga et al. JASN: 2003
Odds ratio=0.98, 95%CI 0.96-0.99, p=0.025
Donadio et al. Nephrol Dial Transplant: 2002
There were 91 patients available for study after 1 year and 18 ESRD events after year one in Trial #1
There were 63 patients available for study after 1 year and 14 ESRD events after one year in Trial #2
1. Steroid therapy during the early stage of progressive IgA nephropathy.
A 10 year follow-up study
Kobayashi et al. Nephron: 1996
2. Corticosteroids in IgA nephropathy: A randomized controlled trial.
Pozzi et al. The Lancet: 1999
3. Steroid treatment for severe childhood IgA nephropathy:A randomized controlled trial.
Yoshikawa et al. Clin J Am Soc Nephrol: 2006
UPEX 1- 3.5g/day, plasma creatinine < 1.5g/day