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Patients With Common Kidney Disease Do Not Need Any Special Treatments

by Kathy Jones on September 8, 2012 at 4:16 PM
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 Patients With Common Kidney Disease Do Not Need Any Special Treatments

A new study published in the Journal of the American Society of Nephrology reveals that patients with a common kidney disease who have only minor urinary abnormalities need no special treatments with their long-term prognosis viewed as excellent.

The findings contrast with earlier, smaller studies and suggest that patients can avoid taking potentially toxic immunosuppressive medications often used to treat the disease.


IgA nephropathy occurs when antibodies build up in the kidneys, which can cause the kidneys to leak blood and proteins into the urine and in some cases can lead to kidney failure. But some patients with IgA nephropathy have normal kidney function and only minor urinary abnormalities at the time of diagnosis. The long-term prognosis of these patients is unclear.

To investigate, Eduardo Gutiérrez, MD, Manuel Praga, MD, PhD (Hospital Universitario 12 de Octubre, in Madrid), and their colleagues studied 141 Caucasian patients with biopsy-proven IgA nephropathy who had normal kidney function, little or no urinary protein leakage, or proteinuria, and who were not taking immunosuppressive medications for their disease.

Among the major findings:

- After 10, 15, and 20 years, 96.7%, 91.9%, and 91.9% of patients maintained blood creatinine levels under a 50% increase from the start, respectively. (Rising creatinine levels indicate declining kidney function.) No patients developed kidney failure.
- Clinical remission occurred in 53 (37.5%) patients after an average of four years.
- 41 (29.1%) patients had no proteinuria.
- At the start of the study, 23 (16.3%) patients had high blood pressure compared with 30 (21.3%) patients at the end of follow-up.
- 59 (41.8%) patients were treated with medications that lower high blood pressure and proteinuria.

"We demonstrate that the long-term prognosis of this type of patient is excellent and that no special treatments other than those needed to lower blood pressure or treat increasing proteinuria are indicated," said Dr. Gutiérrez. "Our reassuring data are important because some previous studies had suggested that IgA nephropathy is a progressive disease even in this type of patient with benign presentation," he added.

Study co-authors include the following investigators in Spain: Isabel Zamora, MD, PhD, José Antonio Ballarín, MD, PhD, Yolanda Arce, MD, Sara Jiménez, MD, Carlos Quereda, MD, PhD, Teresa Olea, MD, Jorge Martínez-Ara, MD, PhD, Alfons Segarra, MD, PhD, Carmen Bernis, MD, PhD, Asunción García, MD, PhD, Marian Goicoechea, MD, PhD, Soledad García de Vinuesa, MD, PhD, and Jorge Rojas-Rivera, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Long-Term Outcomes of IgA Nephropathy Presenting with Minimal or No Proteinuria will appear online at http://jasn.asnjournals.org/ on September 6, 2012, doi: 10.1681/ASN.2012010063.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 13,500 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

Source: Newswise

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