Coppo Rosanna
Fondazione Ricerca Molinette, Ospedale Regina Margherita, Piazza Polonia 94, 10126, Torino, Italy.
J Nephrol. 2017 Jun;30(3):339-346. doi: 10.1007/s40620-016-0360-z. Epub 2016 Nov 4.
The identification of risk factors conditioning the progression of immunoglobulin (Ig)A nephropathy (IgAN) is needed due to the variability of the outcome of this renal disease, which ranges from remission or indolent course to progressive slow loss of renal function or rapidly evolving chronic renal failure. Based on the supposed individual risk of progression, the therapy is modulated from renin-angiotensin inhibitors to corticosteroids, alone or associated with other powerful but potentially harmful immunosuppressors. Over the last 20 years, several studies have produced great advances in the field of biomarkers for detecting risk factors that play a role in the progression of IgAN. This review will focus on the clinical and histological risk factors which have been detected and validated by the majority of the studies and which may presently be considered of value for prognostication of outcome in patients with IgAN, driving the individual treatment choice.
由于免疫球蛋白A（IgA）肾病（IgAN）的病情转归存在差异，从缓解或病情隐匿到肾功能逐渐缓慢丧失或快速进展为慢性肾衰竭，因此需要确定影响IgAN病情进展的危险因素。根据假定的个体进展风险，治疗方案从肾素 - 血管紧张素抑制剂调整为单独使用皮质类固醇或与其他强效但可能有害的免疫抑制剂联合使用。在过去20年中，多项研究在检测IgAN病情进展中起作用的危险因素的生物标志物领域取得了重大进展。本综述将重点关注大多数研究已检测并验证的临床和组织学危险因素，这些因素目前可能被认为对IgAN患者的预后评估有价值，从而指导个体化治疗选择。
