Immunoglobulin A nephropathy and disease complications: register-based studies

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Immunoglobulin A nephropathy and disease complications : register-based studies

Jarrick, Simon, 1977- (author): Örebro universitet,Institutionen för medicinska vetenskaper

Ludvigsson, Jonas, professor, 1969- (thesis advisor): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län

Lundberg, Sigrid (thesis advisor): Department of Nephrology, Danderyd Hospital, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden

Symreng, Adina (thesis advisor): Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden

Geddes, Colin C., docent (opponent): NHS Greater Glasgow and Clyde

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(creator_code:org_t)

ISBN 9789175294834
Örebro : Örebro University, 2023
English 90 s.
Series: Örebro Studies in Medicine, 1652-4063 ; 275

Related links:: https://oru.diva-por... (Preview); show more...; https://oru.diva-por...; https://oru.diva-por...; https://oru.diva-por... (primary) (Raw object); https://urn.kb.se/re...; show less...

Doctoral thesis (other academic/artistic)

Abstract Subject headings

Immunoglobulin A nephropathy (IgAN) is the commonest primary glomerular disease worldwide. A kidney biopsy is required for the diagnosis. IgA immune-complex depositions sets off a cascade leading to renal scarring, proteinuria and hypertension. Peaking in young adults, IgAN contributes significantly to the burden of chronic kidney disease, which in turn may lead to cardiovascular disease and death. As IgAN peaks in childbearing age, its effect on pregnancy outcomes is of interest. All studies use the same cohort of 4126 patients with a biopsy diagnosis of IgAN, identified through the combination of computerized andmanual search in biopsy reports from all Swedish kidney pathology labs. In study I, a random subset of 127 patients from the biopsy cohort were selected for diagnosis validation by patient chart review. IgAN was confirmed or likely in 121 cases (positive predictive value > 95 %). Mean age at diagnosis was 39.6 years, 74 % were male. Study II compared mortality in IgAN patients and an individuallymatched reference population by survival analysis. IgAN was associated with an increase of 53 % in all-cause and 59 % in cardiovascular mortality, with an absolute excess death rate of in 310 person years. Mortality before end-stage renal disease was not significantly increased.Study III used a similar design to examine incident fatal and non-fatal ischemic heart disease (IHD) in IgAN patients and the same reference populations. We found an 86 % increase in IHD hazard and an absolute excess IHD risk of one per 340 person-years. In study IV, outcomes of 327 pregnancies in 208 women with IgAN were compared to reference pregnancies without IgAN, indicating increased odds of preterm birth < 37 weeks gestation, but not for very preterm birth < 34 weeks. Preeclampsia odds were quadrupled. Stillbirth and neonatal death were both uncommon and not increased in IgAN.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Keyword

immunoglobulin A nephropathy
nephrology
validation studies
register studies
cohort studies
mortality
ischemic heart disease
pregnancy
preterm birth

Publication and Content Type

vet (subject category)
dok (subject category)

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By the author/editor: Jarrick, Simon, ...; Ludvigsson, Jona ...; Lundberg, Sigrid; Symreng, Adina; Geddes, Colin C. ...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and General Practice

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