Clinical presentation and diagnosis of IgA nephropathy
- Jonathan Barratt, PhD, FRCP
Jonathan Barratt, PhD, FRCP
- Reader; Honorary Consultant Nephrologist
- University of Leicester, UK
- John Feehally, DM, FRCP
John Feehally, DM, FRCP
- Honorary Professor of Renal Medicine
- University of Leicester, UK
- Section Editors
- Richard J Glassock, MD, MACP
Richard J Glassock, MD, MACP
- Editor-in-Chief — Nephrology
- Section Editor — Glomerular Diseases
- Emeritus Professor
- The David Geffen School of Medicine at UCLA
- Fernando C Fervenza, MD, PhD
Fernando C Fervenza, MD, PhD
- Section Editor — Glomerular Diseases
- Professor of Medicine
- Mayo Clinic College of Medicine
IgA nephropathy is the most common lesion found to cause primary glomerulonephritis throughout most developed countries of the world [1-8]. Patients may present at any age, but there is a peak incidence in the second and third decades of life. There is approximately a 2:1 male to female predominance in North American and Western European populations, although this difference is not observed among populations in the Pacific Rim.
IgA nephropathy occurs with greatest frequency in Asians and Caucasians, and is relatively rare in blacks [4,6,9]. In a Chinese study of 13,519 renal biopsies, for example, IgA nephropathy constituted 45 percent of all cases of primary glomerulonephritis . However, IgA deposits may also be seen on kidney biopsy in individuals with no evidence of renal disease .
The reported incidence of mesangial IgA deposition in apparently healthy individuals ranges from 3 to 16 percent [10,11]. These cases had no clinical features of nephritis but their renal biopsy was consistent with IgA nephropathy.
This observation raises three important points:
●There is a large cohort of undiagnosed "latent" IgA nephropathy in the general population.
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- Oxford classification of IgA nephropathy
- CLINICAL FEATURES
- CLINICAL ASSOCIATIONS
- Cirrhosis and other forms of severe liver disease
- Celiac disease
- HIV infection
- Minimal change disease and membranous nephropathy
- Granulomatosis with polyangiitis (Wegener's)
- Indications for renal biopsy
- Tests of limited utility
- INFORMATION FOR PATIENTS