RT Journal Article
T1 IgA Nephropathy in Elderly Patients.
A1 Sevillano, Angel M
A1 Diaz, Monserrat
A1 Caravaca-Fontan, Fernando
A1 Barrios, Clara
A1 Bernis, Carmen
A1 Cabrera, Jimena
A1 Calviño, Jesus
A1 Castillo, Lorena
A1 Cobelo, Carmen
A1 Delgado-Mallen, Patricia
A1 Espinosa, Mario
A1 Fernandez-Juarez, Gema
A1 Fernandez-Reyes, Maria Jose
A1 Garcia-Osuna, Rosa
A1 Garcia, Patricia
A1 Goicoechea, Marian
A1 Gonzalez-Cabrera, Fayna
A1 Guzman, Diomaris A
A1 Heras, Manuel
A1 Martin-Reyes, Guillermo
A1 Martinez, Alberto
A1 Olea, Teresa
A1 Peña, Jessy Korina
A1 Quintana, Luis F
A1 Rabasco, Cristina
A1 Lopez Revuelta, Katia
A1 Rodas, Lida
A1 Rodriguez-Mendiola, Nuria
A1 Rodriguez, Eva
A1 San Miguel, Luz
A1 Sanchez de la Nieta, Maria Dolores
A1 Shabaka, Amir
A1 Sierra, Milagros
A1 Valera, Alfonso
A1 Velo, Mercedes
A1 Verde, Eduardo
A1 Ballarin, Jose
A1 Noboa, Oscar
A1 Moreno, Juan Antonio
A1 Gutierrez, Eduardo
A1 Praga, Manuel
K1 Angiotensins
K1 Anticoagulants
K1 Biopsy
K1 Erythrocytes
K1 Glomerulonephritis, IGA
K1 Hematuria
K1 IgA nephropathy
K1 Incidence
K1 Kidney function tests
K1 Prognosis
K1 Renal replacement therapy
K1 Renin
K1 Retrospective studies
AB Some studies suggest that the incidence of IgA nephropathy is increasing in older adults, but there is a lack of information about the epidemiology and behavior of the disease in that age group. In this retrospective multicentric study, we analyzed the incidence, forms of presentation, clinical and histologic characteristics, treatments received, and outcomes in a cohort of 151 patients ≥65 years old with biopsy-proven IgA nephropathy diagnosed between 1990 and 2015. The main outcome was a composite end point of kidney replacement therapy or death before kidney replacement therapy. We found a significant increase in the diagnosis of IgA nephropathy over time from six patients in 1990-1995 to 62 in 2011-2015 (P value for trend =0.03). After asymptomatic urinary abnormalities (84 patients; 55%), AKI was the most common form of presentation (61 patients; 40%). Within the latter, 53 (86%) patients presented with hematuria-related AKI (gross hematuria and tubular necrosis associated with erythrocyte casts as the most important lesions in kidney biopsy), and eight patients presented with crescentic IgA nephropathy. Six (4%) patients presented with nephrotic syndrome. Among hematuria-related AKI, 18 (34%) patients were receiving oral anticoagulants, and this proportion rose to 42% among the 34 patients older than 72 years old who presented with hematuria-related AKI. For the whole cohort, survival rates without the composite end point were 74%, 48%, and 26% at 1, 2, and 5 years, respectively. Age, serum creatinine at presentation, and the degree of interstitial fibrosis in kidney biopsy were risk factors significantly associated with the outcome, whereas treatment with renin-angiotensin-aldosterone blockers was associated with a lower risk. Immunosuppressive treatments were not significantly associated with the outcome. The diagnosis of IgA nephropathy among older adults in Spain has progressively increased in recent years, and anticoagulant therapy may be partially responsible for this trend. Prognosis was poor. 
PB American Society of Nephrology
YR 2019
FD 2019-05-01
LK http://hdl.handle.net/10668/14244
UL http://hdl.handle.net/10668/14244
LA en
NO Sevillano AM, Diaz M, Caravaca-Fontán F, Barrios C, Bernis C, Cabrera J, et al. IgA Nephropathy in Elderly Patients. Clin J Am Soc Nephrol. 2019 Aug 7;14(8):1183-1192
DS RISalud
RD Apr 4, 2025