Abstract

BENITEZ LLANES, Orestes; HENRRY PAVIER, Juan Alberto; CASTANER MORENO, Juan  and  FUENTES ABREU, Jorge. Elementos de predicción en la nefropatía por inmunoglobulina A. Rev cubana med [online]. 1996, vol.35, n.1, pp.9-16. ISSN 0034-7523.

A clinical and pathological analysis of all renal biopsies performed between October, 1988 and May, 1993, was made and the presence of IgA nephropathy was evidenced. The objective of this study was to know the incidence of the disease in our environment and identify possible prognostic indicators by clinical manifestations. With the exception of systemic diseases (since there is a multidisciplinary study group in our institution), the most frequent indication for a renal biopsy was the presence of alterations of the urinary sediment (57/161; 35.4 %), mainly hematuria (38/161; 23.6 %). The histologic diagnosis was performed in 51 (89.4 %) out of 57 patient presenting with alterations of the urinary sediment, 14 (30.4 %) had IgA nephropathy, another patient presented with acute nephritis and azotemia not requiring dialytic treatment who subsiquently maintained a clinical picture of persistent microscopic hematuria. IgA nephropathy accounted for 9.3 % (15/161) of the total number of biopsies and 17 % (15/18) of all primary glomerular diseases. Clinical and histological findings were evaluated, as well as modifications of the renal function in all 15 patients presenting with IgA nephropathy, 14 of them presenting with creatinine clearance greater than 70 mL/min at the moment of the renal biopsy. It is concluted that the presence of arterial hypertension, proteinuria, and the histologic pattern of diffuse mesangial proliferation represent a bad prognosis in the course of the disease.

Keywords : BIOPSY. NEEDLE; GLOMERULONEPHRITIS, IgA [diagnosis].