Immunoglobulin A nephropathy and disease complications: register-based studies

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MARC

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

Immunoglobulin A nephropathy and disease complications : register-based studies

BookEnglish2023

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Örebro :Örebro University,2023
90 s.
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-102261
ISBN:9789175294834
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-102261URI

Supplementary language notes

Language:English
Summary in:English

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SwePubSwePub

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Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Series

Örebro Studies in Medicine,1652-4063 ;275

Notes

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 and genre

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

Added entries (persons, corporate bodies, meetings, titles ...)

Ludvigsson, Jonas,professor,1969-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län(Swepub:oru)jsln (thesis advisor)
Lundberg, SigridDepartment of Nephrology, Danderyd Hospital, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden (thesis advisor)
Symreng, AdinaClinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden (thesis advisor)
Geddes, Colin C.,docentNHS Greater Glasgow and Clyde (opponent)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

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

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