Renal Survival Rate Of IgA Nephropathy And Risk Factors

ObjectiveTo study the long-term renal survival of IgA nephropathy and the risk factors influencing prognosis. To investigate the diagnosis of TCM, TCM syndrome type and Chinese medicine intervention on the prognosis of IgA nephropathy.MethodsClinical data, TCM syndrome, laboratory findings, clinicalpathologic data and therapeutic measure of primary IgA nephropathy confirmed by renal biopsy and followed for at least6months were reviewed retrospectively in Guangdong Province Traditional Chinese Medical Hospital. Patients of renal biopsy tissues<10glomerulars, age<18years old, eGFR<30ml/min·1.73m2(MDRD formula) are removed. The definition of serum creatinine values than the baseline levels increased one times above or enter end-stage renal disease (ESRD) as the end event. Kaplan-Meier survival analusis was used to analyze renal survival. Cox regression was used in uni-variate analysis(by ENTER method),P<0.1risk factors included in the multivariate Cox regression analysis (by the LR method) to analyze the independent risk factors of prognosis of IgA nephropathy, and calculated the odd ratio and95%confidence interval of research factors.Results154cases of patients with IgA nephropathy were participated in research, the mean follow-up time were (38.81±25.05) monthes,8(5.2%) cases reached the endpoint. Four of them appeared creatinine doubled, one of them received transplantation, one of them received peritoneal dialysis and two of them received hemodialysis. The1,3,5-year cumulative renal survival rates, calculated by Kaplan-Meier method, were98.6%,93.6%, and91.8%respectively. Uni-variate analysis showed that serum creatinine, Hass typing, renal tubular atrophy, interstitial fibrosis, diagnosis of Chinese medicine, Chinese medicine decoction or proprietary Chinese medicine treatment are risk factors affecting the prognosis of IgA nephropathy (P<0.05). Segmental glome--rular sclerosis(P=0.073)and blood uric acid(P=0.054)into the multivariate Cox regression. The results showed that serum creatinine (P=0.31,0R1.05,95%CI:1.004-1.096), segmental glomerulo sclerosis (P=0.029,0R11.7,95%CI:1.288-107.024) were the independent risk factors for the prognosis of IgA.Conclusion1,5and10-year cumulative renal survival rates were98.6%、91.8%、91.8%respectively. Segmental glomerular sclerosis, serum creatinine are the independent risk factors calculated by multi-variate Cox regression model. The diagnosis and intervention of TCM were the importent factors for the prognosis of IgA.