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IgA Nephropathy in Elderly Patients.

Angel M Sevillano1,2, Monserrat Diaz3, Fernando Caravaca-Fontán1,2

  • 1Department of Nephrology, Hospital Universitario 12 de Octubre, Madrid, Spain.

Clinical Journal of the American Society of Nephrology : CJASN
|July 18, 2019
PubMed
Summary
This summary is machine-generated.

The diagnosis of IgA nephropathy is increasing in older adults. This kidney disease has a poor prognosis in this population, with acute kidney injury being a common presentation.

Keywords:
AngiotensinsAnticoagulantsBiopsyErythrocytesGlomerulonephritis, IGAHematuriaIgA nephropathyIncidenceKidney Function TestsPrognosisRenal Replacement TherapyReninRetrospective Studiesacute kidney injuryacute renal failurealdosteroneanticoagulation therapycreatininehematurianephrotic syndromerisk factors

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Area of Science:

  • Nephrology
  • Epidemiology
  • Geriatric Medicine

Background:

  • Increasing incidence of IgA nephropathy (IgAN) in older adults.
  • Limited data on IgAN epidemiology and clinical behavior in this demographic.

Purpose of the Study:

  • To analyze the incidence, presentation, characteristics, treatment, and outcomes of IgAN in patients aged 65 and older.
  • To identify risk factors and prognostic indicators for IgAN in the elderly.

Main Methods:

  • Retrospective, multicenter study of 151 patients (≥65 years) with biopsy-proven IgAN.
  • Data collected from 1990 to 2015, focusing on incidence, clinical/histologic features, treatments, and outcomes.
  • Primary outcome: kidney replacement therapy or death.

Main Results:

  • Significant increase in IgAN diagnoses over time (P=0.03).
  • Acute kidney injury (AKI) was the most common presentation (40%), often hematuria-related.
  • Poor survival rates: 74% at 1 year, 48% at 2 years, 26% at 5 years.
  • Oral anticoagulant use was common in AKI patients.

Conclusions:

  • IgAN diagnosis is rising in older Spanish adults, potentially linked to anticoagulant use.
  • IgAN in older adults has a poor prognosis.
  • Age, creatinine, and interstitial fibrosis are risk factors; RAAS blockers showed benefit.