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https://www.arca.fiocruz.br/handle/icict/14027
IGA NEPHROPATHY IN BRAZIL: APROPOS OF 600 CASES
Author
Affilliation
Federal University of São Paulo (UNIFESP). Department of Pathology. São Paulo, SP, Brasil / Federal University of Paraná (UFPR). Department of Medical Pathology. Curitiba, PR, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil / Departamento de Patologia Médica. Curitiba, PR, Brasil
Federal Fluminense University (UFF). Department of Pathology. Niterói, RJ, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Santos Metropolitan University (UNIMES). / Ana Costa Hospital. Santos, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of São Paulo (UNIFESP). Department of Pathology. São Paulo, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of Minas Gerais (UFMG). Clinics Hospital. Belo Horizonte, BH, Brasil / Federal University of Ouro Preto (UFOP). Ouro Prêto, MG, Brasil
Santa Casa de Misericórdia de Porto Alegre. Porto Alegre, RS, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of Parana (UFPR). Division of Health Sciences. Curitiba, PR, Brasil
Federal University of São Paulo (UNIFESP). Department of Pathology. São Paulo, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal Fluminense University (UFF). Department of Pathology. Niterói, RJ, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Santos Metropolitan University (UNIMES). / Ana Costa Hospital. Santos, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of São Paulo (UNIFESP). Department of Pathology. São Paulo, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of Minas Gerais (UFMG). Clinics Hospital. Belo Horizonte, BH, Brasil / Federal University of Ouro Preto (UFOP). Ouro Prêto, MG, Brasil
Santa Casa de Misericórdia de Porto Alegre. Porto Alegre, RS, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Federal University of Parana (UFPR). Division of Health Sciences. Curitiba, PR, Brasil
Federal University of São Paulo (UNIFESP). Department of Pathology. São Paulo, SP, Brasil / Brazilian Kidney Club. Brazilian Society of Pathology (SBP). São Paulo, SP, Brasil
Abstract
IgA nephropathy (IgAN) is the commonest primary glomerular disease worldwide. Studies on its prevalence in Brazil
are however scarce. Databases and clinical records from 10 reference centres were retrospectively reviewed. Clinical
and laboratory features at the moment of the biopsy were retrieved (age, gender, presence of hematuria, serum
creatinine [mg/dL], proteinuria [g/24 h]). Renal biopsy findings were classified according to Haas single grade classification
scheme and the Oxford Classification of IgAN. 600 cases of IgAN were identified, of which 568 (94.7 %) were
on native kidneys. Male to female ratio was 1.24:1. Patients averaged 32.76 ± 15.12 years old (range 4–89, median 32).
Proteinuria and hematuria were observed, respectively in 56.63 and 72.29 % of patients. The association of both these
findings occurred in 37.95 % of the cases. Serum creatinine averaged 1.65 ± 0.67 mg/dL (median 1.5 mg/dL) at diagnosis.
Segmental sclerosis and mesangial hypercellularity were the main glomerular findings (47.6 and 46.2 %) The
commonest combination by Oxford Classification of IgAN, was M0 E0 S0 T0 (22.4 %). Chronic tubulo-interstitial lesions
with an extension wider than 25 % of the renal cortex could be identified in 32.2 % of the cases. Tubular atrophy and
interstitial fibrosis were more strongly associated with higher 24-h proteinuria and serum creatinine levels. Segmental
sclerosis (S1) showed a stronger tendency of association with the presence of tubulo-interstitial lesions (T1 and T2)
than other glomerular variables. To the best of our knowledge this is the largest series of IgAN in Brazil. It depicts the
main biopsy findings and their possible clinical correlates. Our set of data is comparable to previous reports.
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