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IgA vasculitis neph...
IgA vasculitis nephritis-outcomes in adult-onset disease
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- Stanway, James (author)
- Royal Free Hosp, England
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- Brown, Nina (author)
- Salford Royal Fdn Trust, England
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- Pervez, Afeera (author)
- Queen Elizabeth Hosp, England
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- van de Perre, Els (author)
- Addenbrookes Hosp, England
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- Tollitt, James (author)
- Salford Royal Fdn Trust, England
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- Marketos, Nikolaos, 1976- (author)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten
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- Wong, Nikki (author)
- Imperial Coll London, England
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- Dhaygude, Ajay (author)
- Royal Preston Hosp, England
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- Ponnusamy, Arvind (author)
- Royal Preston Hosp, England
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- O'Riordan, Ed (author)
- Salford Royal Fdn Trust, England
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- Venning, Michael (author)
- Manchester Royal Infirm, England
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- Segelmark, Marten (author)
- Lund Univ, Sweden
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- Morgan, Matthew (author)
- Queen Elizabeth Hosp, England
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- Jayne, David (author)
- Addenbrookes Hosp, England
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- Hamilton, Patrick (author)
- Manchester Royal Infirm, England
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- Pusey, Charles D. (author)
- Imperial Coll London, England
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- Oni, Louise (author)
- Alder Hey Childrens NHS Fdn Trust Hosp, England
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- Salama, Alan D. (author)
- Royal Free Hosp, England
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(creator_code:org_t)
- 2024
- 2024
- English.
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In: Rheumatology. - : OXFORD UNIV PRESS. - 1462-0324 .- 1462-0332.
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Objectives: IgA vasculitis (IgAV) in adults has been relatively under-investigated. Since outcomes are worse in other forms of vasculitis with increasing age, we investigated the outcomes of IgAV comparing younger adults (18-34), middle-aged adults (35-64) and elderly patients (>= 64 years) focusing on kidney outcomes. Methods: We identified patients with renal biopsy-confirmed IgAV nephritis and collected data regarding clinical features and progression to end stage kidney disease (ESKD). The relationship between patient factors and ESKD was analysed by regression. Results: We identified 202 cases, 34% aged 18-34, 43% aged 35-64 and 23% elderly (>64 years). Median follow-up was 44 months. Elderly patients were more likely to present with ESKD (23.9%) compared with middle-aged (13.7%) and younger adults (2.9%) (chi(2 )11.6, P = 0.002). In patients with independent kidney function at biopsy, there was no difference in outcomes between age groups. Male gender, Black ethnicity, diabetes, histological evidence of chronic renal damage and estimated glomerular filtration rate < 30 ml/min were risk factors for development of ESKD. In this observational study 68.3% of patients received glucocorticoids and 56.9% additional immunosuppression. Conclusion: Elderly patients with IgAV are more likely to have ESKD at presentation, but there is no difference in renal survival between age groups, among those presenting with independent renal function. Renal impairment at biopsy is an independent risk factor for subsequent development of ESKD. There is significant variability in the timing of kidney biopsy and management of these patients among specialist centres. Young adults have outcomes more in keeping with childhood IgAV.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Odontologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dentistry (hsv//eng)
Keyword
- IgA vasculitis; Henoch-Schonlein purpura; end stage renal disease (ESKD); elderly; adult
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Stanway, James
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Brown, Nina
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Pervez, Afeera
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van de Perre, El ...
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Tollitt, James
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Marketos, Nikola ...
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show more...
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Wong, Nikki
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Dhaygude, Ajay
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Ponnusamy, Arvin ...
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O'Riordan, Ed
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Venning, Michael
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Segelmark, Marte ...
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Morgan, Matthew
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Jayne, David
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Hamilton, Patric ...
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Pusey, Charles D ...
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Oni, Louise
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Salama, Alan D.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Dentistry
- Articles in the publication
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Rheumatology
- By the university
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Linköping University