IgA nephropathy in Thailand : A long term analysis of patients with good initial renal function

We retrospectively studied 52 cases of adult biopsy proven IgA nephropathy. All had initial serum creatinine less than 1.5 mg/dl (mean and SEM of Ccr = 91.3 ± 3.43 ml/minute). The mean follow up duration was 64.2 months. Thirty and forty-three % of these patients had renal insufficiency (Ccr 1g/day, serum uric acid > 7mg%, moderate to severe glomerulosclerosis, interstitial fibrosis, tubular atrophy and arteriosclerosis. Cox proportional hazard regression showed that interstitial fibrosis was the strongest prognostic factor (Relative risk = 7.064). Our study suggested that IgA nephropathy in this tropical country is not a benign condition and may have more aggressive natural history than that in western countries.