Nefropatía por Iga: la principal glomerulonefritis primaria del mundo

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Andrés Eduardo Toro Montoya
  • Biografía

    Estudiante de Medicina de la Universidad Pontificia Bolivariana, Semillero de Investigación Facultad de Medicina (SIFAM).

Cristian Camilo Benítez Restrepo
  • Biografía

    Docente Titular de la Facultad de Medicina de la Universidad Pontificia Bolivariana, SIFAM.

Lina María Martínez Sánchez
  • Biografía

    Bacterióloga, Esp. en Hematología y Banco de Sangre. Coordinadora Semillero de Investigación de la Facultad de Medicina (SIFAM). Profesora Titular Universidad Pontificia Bolivariana.

Resumen

La Nefropatía por IgA es una patología glomerular proliferativa mesangial, mediada por complejos inmunes, generada por el depósito de globulina tipo A; se considera la primera causa de glomérulonefritis primaria en el mundo. Se calcula que afecta al 1.3% de la población. Su incidencia es variable, pues se estima así: en Asia 29%, en Australia 12%, en Europa 10% y en Estados Unidos 10-15%. Es más frecuente en hombres que en mujeres con relación 6:1 a 10:1 y se presenta, principalmente, entre los 16 a los 40 años. Es una glomerulopatía que tiene curso clínico variable y que puede conducir a Insuficiencia Renal Terminal, con la consecuencia social y económica que ello implica. Actualmente, se tiene mayor conocimiento sobre su evolución, factores de riesgo para el desarrollo de falla renal terminal y nuevas alternativas terapéuticas. Por ellos, es importante establecer en este tipo de pacientes sus características clínicas e histopatológicas para determinar el comportamiento de la población con este diagnóstico y definir el manejo más adecuado, tanto en forma individual como colectiva.

Palabras clave:
Glomerulonephritis, IgA, , prognosis, kidney diseases, proteinuria Glomerulonefritis por IgA, pronóstico, enfermedades del riñón, proteinuria

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Referencias

Berger J, Hinglais N. Intercapillary deposits of IgA-IgG. J Urol Nephrol. París. 1968;74(9):694-5.

Rosselli-S C, Castelo-M S, Rondreos S, Ronderos I. Nefropatía por IgA. En: Borrero-R J, Montero-G O. Nefrología. 4 ed. Medellín: CIB; 2003. p. 323-329.

Kern BE, di Rocco D, Lütschg J, Lüthy C, Zimmermann A, Gerber HA, et al. Demonstration of mesangial IgA deposits in kidney biopsies of pediatric patients: comparison with the clinical picture. Praxis. 1995; 84(41):1158-64.

Julian BA, Waldo FB, Rifai A, Mestecky J. IgA nephropathy, the most common glomerulonephritis worldwide: a neglected disease in the United States? Am J Med. 1988;84:129-32.

Rychlik I, Andrassy K, Waldherr R, Zuna I, Tesar V, Jancová E, Stejskalová A, Ritz E. Clinical features and natural history of IgA nephropathy. Ann Med Interne. 1999;150(2):117-26.

Frohnert PP, Sterioff S. Twenty-five years of renal transplantation at Mayo Clinic Clin Transpl. 1989;1:267- 74.

Bene MC, Faure GC. Mesangial IgA in IgA nephropathy arises from the mucosa. Am J Kidney Dis. 1988;12:406- 9.

Feehally J, Allen AC. Pathogenesis of IgA nephropathy. Ann Med Interne. 1999; 150:91-8.

Grande JP. Role of transforming growth factor-beta in tissue injury and repair. Proc Soc Exp Biol Med. 1997;214(1):27-40.

Donadio JV, Grande JP. IgA nephropathy. N Engl J Med. 2002;347(10):738-48.

D’Amico G. Natural history of idiopathic IgA nephropathy: role of clinical and histological prognostic factors. Am J Kidney Dis. 2000;36(2):227-37.

Lee HS, Lee MS, Lee SM, Lee SY, Lee ES, Lee EY, Park SY, Han JS, Kim S, Lee JS. Histological grading of IgA nephropathy predicting renal outcome: revisiting H. S. Lee’s glomerular grading system. Nephrol Dial Transplant. 2005;20(2):342-8.

To KF, Choi PC, Szeto CC, Li PK, Tang NL, Leung CB, et al. Outcome of IgA nephropathy in adults graded by chronic histological lesions. Am J Kidney Dis. 2000;35(3):392-400.

Daniel L, Saingra Y, Giorgi R, Bouvier C, Pellissier JF, Berland Y. Tubular lesions determine prognosis of IgA nephropathy. Am J Kidney Dis. 2000;35(1):13-20.

Kobayashi Y, Tateno S, Hiki Y, Shigematsu H. IgA nephropathy: prognostic significance of proteinuria and histological alterations. Nephron. 1983;34(3):146-53.

Yang NS, Wu QQ, Du Y, Zhang R, Li YJ, Ye RG, Yu XQ. Risk factors affecting the long-term outcome of IgA nephropathy. Zhonghua Nei Ke Za Zhi. 2005;44(8):597- 600.

Donadio JV, Bergstralh EJ, Bibus DM, Grande JP. Is body size a biomarker for optimizing dosing of omega-3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy?. Clin J Am Soc Nephrol. 2006;1(5):933-9.

Coppo R, D’Amico G. Factors predicting progression of IgA nephropathies. J Nephrol. 2005; 18(5):503-12.

Nozawa R, Suzuki J, Takahashi A, Isome M, Kawasaki Y, Suzuki S, Suzuki H. Clinicopathological features and the prognosis of IgA nephropathy in Japanese children on long-term observation. Clin Nephrol. 2005;64(3):171-9.

Komatsu H, Fujimoto S, Hara S, Sato Y, Yamada K, Eto T, Nakao H. Multivariate analysis of prognostic factors and effect of treatment in patients with IgA nephropathy. Ren Fail. 2005; 27(1):45-52.

Li PK, Ho KK, Szeto CC, Yu L, Lai FM. Prognostic indicators of IgA nephropathy in the Chinese--clinical and pathological perspectives. Nephrol Dial Transplant. 2002;17(1):64-9.

Rekola S, Bergstrand A, Bucht H. IGA nephropathy: a retrospective evaluation of prognostic indices in 176 patients. Scand J Urol Nephrol. 1989;23(1):37-50.

Eiro M, Katoh T, Kuriki M, Asano K, Watanabe K, Watanabe T. The product of duration and amount of proteinuria (proteinuria index) is a possible marker for glomerular and tubulointerstitial damage in IgA nephropathy. Nephron. 2002;90(4):432-41.

Bartosik LP, Lajoie G, Sugar L, Cattran DC. Predicting progression in IgA nephropathy. Am J Kidney Dis. 2001;38(4):728-35.

Neelakantappa K, Gallo GR, Baldwin DS. Proteinuria in IgA nephropathy. Kidney Int. 1988; 33(3):716-21.

Shen P, He L, Huang D. Clinical course and prognostic factors of clinical early IgA nephropathy. Neth J Med. 2008;66(6):242-7.

Shen P, He L, Li Y, Wang Y, Chan M. Natural history and prognostic factors of IgA nephropathy presented with isolated microscopic hematuria in Chinese patients. Nephron Clin Pract. 2007; 106(4):c157-61.

Ibels LS, Györy AZ. IgA nephropathy: analysis of the natural history, important factors in the progression of renal disease, and a review of the literature. Medicine. 1994;73(2):79-102.

Lv J, Zhang H, Zhou Y, Li G, Zou W, Wang H. Natural history of immunoglobulin A nephropathy and predictive factors of prognosis: a long-term follow up of 204 cases in China. Nephrology. 2008; 13(3):242-6.

Locatelli F, Marcelli D, Comelli M, Alberti D, Graziani G, Buccianti G, Redaelli B, Giangrande A. Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Northern Italian Cooperative Study Group. Nephrol Dial Transplant. 1996;11(3):461- 7.

Chacko B, John GT, Neelakantan N, Korula A, Balakrishnan N, Kirubakaran MG, Jacob CK. Presentation, prognosis and outcome of IgA nephropathy in Indian adults. Nephrology. 2005; 10(5):496-503.

Petrović L, Curić S, Mitić I, Bozić D, Vodopivec S, Sakac V, Durdević-Mirković T, Ilić T. Immunoglobulin A nephropathy and disease prognostic factors. Med Pregl. 2002;55(11-12):517-22.

D’Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome. Semin Nephrol. 2004;24(3):179-96.

Muthukumar T, Fernando ME, Jayakumar M. Prognostic factors in immunoglobulin-A nephropathy. J Assoc Physicians India. 2002;50:1354-9.

Frimat L, Hestin D, Aymard B, Mayeux D, Renoult E, Kessler M. IgA nephropathy in patients over 50 years of age: a multicentre, prospective study. Nephrol Dial Transplant. 1996;11(6):1043-7.

Rai A, Nast C, Adler S. Henoch-Schönlein purpura nephritis. J Am Soc Nephrol. 1999; 10(12):2637-44.

Lilien MR, Donckerwolcke RA, Vroom TM. HenochSchoenlein purpura- nephritis followed by IgA-nephritis in 3 children. Ned Tijdschr Geneeskd. 1996;140(6):316- 9.

D’Amico G, Colasanti G, Barbiano di Belgioioso G, et al. Long-term follow-up of IgA mesangial nephropathy: clinico-histological study in 374 patients. Semin Nephrol. 1987;7:355-8.

Cheng IK, Chan PC, Chan MK. The effect of fish-oil dietary supplement on the progression of mesangial IgA glomerulonephritis. Nephrol Dial Transplant. 1990;5(4):241-6.

Hotta O. Tonsillectomy combined with steroid pulse therapy: a curative therapy for IgA nephropathy. Acta Otolaryngol Suppl. 2004;(555):43-8.

Miyazaki M, Hotta O, Komatsuda A, Nakai S, Shoji T, Yasunaga C, Taguma Y; Japanese Multicenter Study Group on Treatment of IgA Nephropathy (JST-IgAN). A multicenter prospective cohort study of tonsillectomy and steroid therapy in Japanese patients with IgA nephropathy: a 5-year report. Contrib Nephrol. 2007;157:94-8.

Furuta T, Hotta O, Horigome I, Chiba S, Noshiro H, Miyazaki M, Satoh M, Honda S, Taguma Y. Steroid pulse therapy combined with tonsillectomy in IgA nephropathy associated with diabetes mellitus. Nephron. 2001;89(4):398-401.

Hotta O, Miyazaki M, Furuta T, Tomioka S, Chiba S, Horigome I, Abe K, Taguma Y. Tonsillectomy and steroid pulse therapy significantly impact on clinical remission in patients with IgA nephropathy. Am J Kidney Dis. 2001;38(4):736-43.

Kawamura T. Treatment of IgA Nephropathy: Corticoteroids, Tonsillectomy, and Mycophenolate Mofetil. Contrib Nephrol. 2007;157:37-43.

Lv J, Zhang H, Chen Y, Li G, Jiang L, Singh AK, Wang H. Combination Therapy of Prednisone and ACE Inhibitor Versus ACE-Inhibitor Therapy Alone in Patients With IgA Nephropathy: A Randomized Controlled Trial. Am J Kidney Dis. 2008;52(4):647-58.

Ohtake T, Oka M, Maesato K, Mano T, Ikee R, Moriya H, Kobayashi S. Pathological regression by angiotensin II type 1 receptor blockade in patients with mesangial proliferative glomerulonephritis. Hypertens Res. 2008;31(3):387-94.

Xu G, Tu W, Jiang D, Xu C. Mycophenolate Mofetil Treatment for IgA Nephropathy: A Meta-Analysis. Am J Nephrol. 2008; 29(5):362-67.

D’Amico G. The commonest glomerulonephritis in the world: IgA nephropathy. Q J Med 1987; 245:709-27.

Tan CH, Loh PT, Yang WS, Chan CM. Mycophenolate mofetil in the treatment of IgA nephropathy: a systematic review. Singapore Med J. 2008;49(10):780-5.

Navaneethan SD, Viswanathan G, Strippoli GF. Metaanalysis of mycophenolate mofetil in IgA nephropathy. Nephrology. 2008;13(1):90.

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