34
IRUS Total
Downloads
  Altmetric

The natural history of immunoglobulin M nephropathy in adults

File Description SizeFormat 
IgM nephropathy, Connor et al.docxAccepted version1.87 MBMicrosoft WordView/Open
Title: The natural history of immunoglobulin M nephropathy in adults
Authors: Connor, TM
Aiello, V
Griffith, M
Cairns, T
Roufosse, CA
Cook, HT
Pusey, CD
Item Type: Journal Article
Abstract: BACKGROUND: Immunoglobulin M (IgM) nephropathy is an idiopathic glomerulonephritis characterized by diffuse mesangial deposition of IgM. IgM nephropathy has been a controversial diagnosis since it was first reported, and there are few data identifying specific pathological features that predict the risk of progression of renal disease. METHODS: We identified 57 cases of IgM nephropathy among 3220 adults undergoing renal biopsy at our institution. Biopsies had to satisfy the following three criteria to meet the definition of IgM nephropathy in this study: (i) dominant mesangial staining for IgM, (ii) mesangial deposits on electron microscopy (EM) and (iii) exclusion of systemic disease. RESULTS: The median age was 42 years and 24 patients were male. Thirty-nine per cent of patients presented with the nephrotic syndrome, 49% presented with non-nephrotic proteinuria and 39% had eGFR <60 mL/min. The median post-biopsy follow-up was 40 months and serum creatinine had doubled in 31% by 5 years. Of histological parameters, glomerular sclerosis and tubular atrophy, but not mesangial proliferation, were risk factors for renal insufficiency. Thirty-nine per cent of nephrotic patients achieved complete remission, and outcome was significantly worse in those who did not respond to treatment. Focal segmental glomerulosclerosis was diagnosed in 80% of those undergoing repeat renal biopsy, despite ongoing mesangial IgM deposition. CONCLUSIONS: We propose criteria for a consensus definition of IgM nephropathy.
Issue Date: 15-Apr-2016
Date of Acceptance: 1-Mar-2016
URI: http://hdl.handle.net/10044/1/34185
DOI: https://dx.doi.org/10.1093/ndt/gfw063
ISSN: 1460-2385
Publisher: Oxford University Press
Start Page: 823
End Page: 829
Journal / Book Title: Nephrology Dialysis Transplantation
Volume: 32
Issue: 5
Copyright Statement: © 2016 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Nephrology Dialysis Transplantation following peer review. The definitive publisher-authenticated version is available online at: http://dx.doi.org/10.1093/ndt/gfw063.
Sponsor/Funder: National Institute for Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: NF-SI-0611-10055
RDA04 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
Transplantation
Urology & Nephrology
glomerulonephritis
immunoglobulin M
nephrotic syndrome
outcome
renal biopsy
MESANGIAL PROLIFERATIVE GLOMERULONEPHRITIS
MINIMAL-CHANGE DISEASE
NEPHROTIC SYNDROME
IGM-NEPHROPATHY
OXFORD CLASSIFICATION
CLINICAL-PICTURE
C1Q NEPHROPATHY
FOLLOW-UP
DEPOSITS
GLOMERULOPATHY
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Department of Medicine (up to 2019)