IgA nephropathy--Groote Schuur Hospital experience

The prevalence of IgA nephropathy among 872 renal biopsies performed at Groote Schuur Hospital over a period of 7 years was retrospectively examined. Only 34 cases were shown to have IgA nephropathy. The features of these biopsies were compared with clinical and biochemical findings at the time of biopsy. The average age at histological diagnosis was 28.5 years (range 13-61 years); there were 25 males and 9 females. All patients had hematuria and in 44% it was macroscopic at some stage. Five of 25 patients in whom 24-hour urinary protein excretion was measured excreted more than 3.5 g/day. Histological changes ranged from mild proliferative changes (grade 1) to crescents and sclerosis (grades 4 and 5). There was a significant correlation between histological grade and serum creatinine (p less than 0.004) and proteinuria (p less than 0.005). The low prevalence of the disease in our total renal biopsy experience (3.8%) is similar to that reported from the United States (1.5) and England (4%). The age and clinical findings at the time of diagnosis were similar to most other series. The sex ratio was equal in the mixed-origin race group, while amongst the whites, males predominated. No IgA nephropathy was found in biopsies from blacks, which supports the observation of others that this condition is rare in the black population.