Some patients with common kidney disease can skip standard treatments

For patients with a common kidney disease who have normal kidney function and only minor urinary abnormalities at the time of diagnosis, the long-term prognosis is excellent and no special treatments are needed, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). 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 . 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 with biopsy-proven IgA nephropathy who had normal kidney function, little or no urinary protein leakage, or , 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 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.

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

add to favorites email to friend print save as pdf

Related Stories

Blood markers reveal severity of common kidney disease

Aug 16, 2012

Increasing blood levels of particular proteins may act as warning signs for patients with one of the most common diseases of the kidney, according to a study appearing in an upcoming issue of the Journal of the American So ...

Avosentan reduces proteinuria but causes serious side effects

Feb 18, 2010

The drug avosentan substantially reduces urinary protein loss in people with type 2 diabetes and kidney disease, but the drug causes serious side effects, according to a study appearing in an upcoming issue of the Journal of ...

Recommended for you

Recorded Ebola deaths top 7,000

7 hours ago

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

11 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.