Does pregnancy influence the course of IgA nephropathy? Proposal for an observational study

Whether or not pregnancy adversely affects the course of IgA nephropathy (IgAN) remains a matter of debate. Studies have produced conflicting results to date, probably due to differences in patient selection, renal disease severity, grades of hypertension and proteinuria or the administration of different therapies. Since numerous variables can influence the long-term outcome, it is necessary to evaluate data from a large number of patients to minimize the effect of confounding factors. However, the number of patients considered in most studies is small, and long-term prognosis is not yet reported in the literature. In the case of a chronic disease with a slow course such as IgAN, a long observation period is needed to draw substantial conclusions about the prognostic value of pregnancy. We propose a multicenter, retrospective, observational study to clarify whether pregnancy negatively affects the long-term prognosis of women with IgAN. Data of women who became pregnant and of women who did not conceive during the follow-up will be collected at the time of renal biopsy and every 5 yrs to evaluate possible differences in the course of maternal renal disease between the two groups. In particular, the following endpoints will be compared: renal function and the onset of hypertension and proteinuria. Possible differences in therapy will be analyzed to investigate whether different treatment approaches in the two groups could have influenced the disease course.