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2020 ; 21
(1
): 10-17
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Gastrointestinal bleeding is associated with renal prognosis in adult patients
with IgA vasculitis with nephritis
#MMPMID31911884
Shimamura Y
; Maeda T
; Nishizawa K
; Ogawa Y
; Takizawa H
J Gen Fam Med
2020[Jan]; 21
(1
): 10-17
PMID31911884
show ga
BACKGROUND: Although the prediction of renal prognosis in patients with IgA
vasculitis with nephritis (IgAVN) is important, the association between
gastrointestinal bleeding (GIB) and its renal prognosis is unknown. This study
investigated the effect of GIB on the progression to end-stage kidney disease
(ESKD) in patients with IgAVN. METHODS: We compared the clinicopathological
findings at diagnosis, therapy, and clinical outcomes between 10 patients with
GIB and 20 patients without GIB in 30 patients with IgAVN aged ?18 years at the
renal biopsy. The primary outcome was the incidence of ESKD. Secondary outcomes
included clinical remission and all-cause mortality. The outcomes and factors
affecting the progression to ESKD were evaluated using the Kaplan-Meier method
with log-rank test and Cox proportional hazards models. RESULTS: End-stage kidney
disease, clinical remission, and deaths from any related cause occurred in 6, 17,
and 2 patients, respectively. In Kaplan-Meier analyses, the GIB group showed a
higher incidence of ESKD (50% vs 5%, P = .003) and a lower incidence of clinical
remission (20% vs 75%, P = .003). Although the numbers were not statistically
significant, this group tended to have a greater number of deaths than the
non-GIB group (7% vs 0%, P = .07). In a multivariable Cox model adjusted for
hypertension and urinary proteinuria, GIB could not demonstrate a significant
association with ESKD (hazard ratio, 4.51; 95% confidence interval, 0.39-52.7;
P = .23). CONCLUSION: IgAVN with GIB has worse renal outcome, but GIB does not
have a statistically significant association with progression to ESKD.
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