The Future: An Australian Perspective

The recognition of Berger’s disease is still relatively recent and awareness of its high prevalence and true functional importance is even more so. Therefore, one of our first obligations should be to educate the profession with respect to the diagnostic importance of IgA nephropathy as a frequent cause of hematuria, proteinuria, hypertension, and renal failure. In doing so, we should stress the significance of “synpharyngitic” hematuria and of the presence of “glomerular type” red blood cells in the urine and referral for renal biopsy should be advocated as the definitive investigation in such patients. Without such promotion, the condition will continue to be underdiagnosed and its true prevalence grossly understated. In turn, we need to carry out formal epidemiologic and life-table analytic studies of IgA nephropathy, as exemplified by Sinniah et al. in Singapore [1, 2] and D’Amico in Milan [3].