Hastings M Colleen, Bursac Zoran, Julian Bruce A, Villa Baca Emanuel, Featherston Jennifer, Woodford Susan Y, Bailey Lisa, Wyatt Robert J
Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Department of Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Kidney Int Rep. 2017 Aug 24;3(1):99-104. doi: 10.1016/j.ekir.2017.08.008. eCollection 2018 Jan.
Although end-stage renal disease (ESRD) and surrogate markers for renal dysfunction are frequently used as outcome markers for IgA nephropathy, the clinical course after reaching ESRD is not well documented. This study examined outcomes of progression to ESRD and age at death in a cohort of adults with IgA nephropathy with a long duration of follow-up.
Patient and kidney survival of 251 adult patients with IgA nephropathy from the southeastern United States diagnosed between January 1, 1976 and December 31, 2005 were analyzed.
Median age at diagnosis was 36.9 years. Most patients were men (69%) and Caucasian (95%). Only 46% had an estimated glomerular filtration rate >60 ml/min per 1.73 m at diagnosis. Mean follow-up time from time of diagnostic biopsy to death or end of study was 19.3 years. Of 251 patients, 132 (53%) progressed to ESRD and 97 (39%) died. Life expectancy was reduced by 10.1 years, with a median observed age of death at 65.7 years and a median expected age at death of 75.8 years. Eighty-three percent of the deaths occurred after progression to ESRD.
Life expectancy is substantially reduced for patients diagnosed with IgA nephropathy in the southeastern United States.
尽管终末期肾病（ESRD）及肾功能不全的替代标志物常被用作IgA肾病的预后指标，但ESRD发生后的临床病程尚无充分记录。本研究在一组长期随访的成年IgA肾病患者中，考察了进展至ESRD的预后情况及死亡年龄。
分析了1976年1月1日至2005年12月31日期间在美国东南部诊断的251例成年IgA肾病患者的患者及肾脏生存率。
诊断时的中位年龄为36.9岁。大多数患者为男性（69%）且为白种人（95%）。诊断时仅46%的患者估计肾小球滤过率>60 ml/（min·1.73 m²）。从诊断性活检至死亡或研究结束的平均随访时间为19.3年。251例患者中，132例（53%）进展至ESRD，97例（39%）死亡。预期寿命缩短了10.1岁，观察到的中位死亡年龄为65.7岁，预期中位死亡年龄为75.8岁。83%的死亡发生在进展至ESRD之后。
在美国东南部，诊断为IgA肾病的患者预期寿命大幅缩短。
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