Primary IgA nephropathy in elderly patients

Wisit Cheungpasitporn, Samih H. Nasr, Charat Thongprayoon, Michael A. Mao, Qi Qian

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Aim Data on clinicopathological features, treatment and outcomes of IgA nephropathy (IgAN) in elderly patients are limited. Methods Native kidney biopsies with a pathological diagnosis of IgAN (n = 1084) from Mayo Clinic Rochester in the years 1994-2013 were examined. After exclusion of the secondary IgAN, 45 elderly IgAN patients (age ≥65 years) were identified. One hundred sixty-two younger adults (age 18-64 years) with IgAN were randomly selected for comparison. Results Compared with younger adults, elderly patients showed a higher rate of chronic hypertension (62.2 vs 27.2%), higher pulse pressures (65 ± 17 vs 51 ± 15 mmHg), requiring greater number of antihypertensive medications (2.5 ± 1.2 vs 1.7 ± 0.7) and lower blood haemoglobin (11.1 ± 2.3 vs 12.7 ± 2.1 g/dL) at time of kidney biopsy, all P < 0.001. Pathologically, elderly kidneys showed a higher degree of tubulointerstitial fibrosis (P = 0.04) and vascular sclerosis (P < 0.001). Treatments (including the use of angiotensin-converting enzyme inhibitor (ACEI) inhibitor, angiotensin II receptor blocker (ARB) and immunosuppressants) were similar in the two cohorts. Elderly patients had more end-stage renal disease at 6 months (HR 5.51; 95% CI 1.46-22.3, P = 0.01) and higher 6-month and 5-year mortality (HR 2.31; 95% CI 1.04-5.17, P = 0.04) after adjusting the age and comorbidities. Conclusion IgAN diagnosed at age >65 years tends to have a faster renal disease progression and higher patient mortality. Summary at a Glance Results of the study showed that IgA nephropathy (IgAN) diagnosed at age >65 years tends to have faster renal disease progression and lower renal and patient survival. This is mainly due to a high rate of hypertension and tubulointerstitial changes and vascular sclerosis observed on kidney biopsy. Reviewer 2 expressed an interest to write an Editorial which I support.

Original languageEnglish (US)
Pages (from-to)419-425
Number of pages7
JournalNephrology
Volume20
Issue number6
DOIs
StatePublished - Jun 1 2015

Keywords

  • chronic kidney disease
  • elderly patient
  • end-stage renal failure
  • kidney disease progression
  • mortality
  • primary IgA nephropathy

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Primary IgA nephropathy in elderly patients'. Together they form a unique fingerprint.

  • Cite this

    Cheungpasitporn, W., Nasr, S. H., Thongprayoon, C., Mao, M. A., & Qian, Q. (2015). Primary IgA nephropathy in elderly patients. Nephrology, 20(6), 419-425. https://doi.org/10.1111/nep.12440