Immunoglobulin A nephropathy in association with inflammatory bowel diseases: results from a national study and systematic literature review.

Biopsy Glomerular Filtration Rate Glomerulonephritis, IGA / complications Humans Inflammatory Bowel Diseases / complications Kidney Multicenter Studies as Topic Renal Dialysis Retrospective Studies
Crohn’s disease IgA nephropathy chronic kidney disease inflammatory bowel disease ulcerative colitis

Journal

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
ISSN: 1460-2385
Titre abrégé: Nephrol Dial Transplant
Pays: England
ID NLM: 8706402

Informations de publication

Date de publication:
25 02 2022
Historique:
received: 20 07 2020
pubmed: 9 1 2021
medline: 23 3 2022
entrez: 8 1 2021
Statut: ppublish

Résumé

Little is known about clinical characteristics and kidney outcomes in patients with biopsy-proven immunoglobulin A nephropathy (IgAN) in a context of inflammatory bowel disease (IBD). We conducted a retrospective multicentre study with a centralized histological review to analyse the presentation, therapeutic management and outcome of 24 patients suffering from IBD-associated IgAN relative to a cohort of 134 patients with primary IgAN without IBD. Crohn's disease and ulcerative colitis accounted for 75 and 25% of IBD-associated IgAN cases, respectively. IBD was diagnosed before IgAN in 23 cases (a mean of 9 years previously) and was considered active at IgAN onset in 23.6% of patients. Hypertension was present in 41.7% of patients. The urinary protein:creatinine ratio exceeded 100 mg/mmol in 70.8% of patients (mean 254 mg/mmol). Estimated glomerular filtration rate (eGFR) was >60 mL/min/1.73 m2 in 13/24 patients and only 1 patient required dialysis. In the Oxford mesangial hypercellularity, endocapillary cellularity, segmental sclerosis and interstitial fibrosis/tubular atrophy with crescents classification of renal biopsies, 57% were M1, 48% E1, 76% S1, 57% T1-2 and 38% C1-2. Steroids were administered in 50% of cases. After a mean follow-up of 7.2 years, 4 patients (16.7%) had a poor kidney outcome: end-stage renal disease (n = 3) or a >50% decrease in eGFR from initial values (n = 1). A similar evolution was observed in patients with primitive IgAN. This first case series suggests that IBD-associated IgAN has frequent inflammatory lesions at onset and variable long-term outcomes.

Sections du résumé

BACKGROUND
Little is known about clinical characteristics and kidney outcomes in patients with biopsy-proven immunoglobulin A nephropathy (IgAN) in a context of inflammatory bowel disease (IBD).
METHODS
We conducted a retrospective multicentre study with a centralized histological review to analyse the presentation, therapeutic management and outcome of 24 patients suffering from IBD-associated IgAN relative to a cohort of 134 patients with primary IgAN without IBD.
RESULTS
Crohn's disease and ulcerative colitis accounted for 75 and 25% of IBD-associated IgAN cases, respectively. IBD was diagnosed before IgAN in 23 cases (a mean of 9 years previously) and was considered active at IgAN onset in 23.6% of patients. Hypertension was present in 41.7% of patients. The urinary protein:creatinine ratio exceeded 100 mg/mmol in 70.8% of patients (mean 254 mg/mmol). Estimated glomerular filtration rate (eGFR) was >60 mL/min/1.73 m2 in 13/24 patients and only 1 patient required dialysis. In the Oxford mesangial hypercellularity, endocapillary cellularity, segmental sclerosis and interstitial fibrosis/tubular atrophy with crescents classification of renal biopsies, 57% were M1, 48% E1, 76% S1, 57% T1-2 and 38% C1-2. Steroids were administered in 50% of cases. After a mean follow-up of 7.2 years, 4 patients (16.7%) had a poor kidney outcome: end-stage renal disease (n = 3) or a >50% decrease in eGFR from initial values (n = 1). A similar evolution was observed in patients with primitive IgAN.
CONCLUSIONS
This first case series suggests that IBD-associated IgAN has frequent inflammatory lesions at onset and variable long-term outcomes.

Identifiants

DOI: 10.1093/ndt/gfaa378 PMID: 33416845
pubmed: 33416845
pii: 6070155
doi: 10.1093/ndt/gfaa378
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

531-539

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of the ERA.

Auteurs

Nizar Joher (N)

Département de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Hôpital Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris AP-HP, Créteil, France.
Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Université Paris Est Créteil UPEC, Equipe 21, Créteil, France.

Clément Gosset (C)

Département de Pathologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris AP-HP, Paris, France.

Dominique Guerrot (D)

Département de Néphrologie, Hôpital Universitaire de Rouen, Rouen, France.
ORCID: 0000-0002-5953-5785

Evangeline Pillebout (E)

Département de Néphrologie, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.

Aurélie Hummel (A)

Département de Néphrologie, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.

Jean-Jacques Boffa (JJ)

Département de Néphrologie, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France.

Stanislas Faguer (S)

Département de Néphrologie, Hôpital Rangueil, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.

Marion Rabant (M)

Département de Pathologie, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.

Sarah Higgins (S)

Département de Pathologie, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.

Anissa Moktefi (A)

Département de Pathologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.
ORCID: 0000-0002-6015-3979

Yahsou Delmas (Y)

Département de Néphrologie, Hôpital Universitaire de Bordeaux, Bordeaux, France.

Alexandre Karras (A)

Département de Néphrologie, Hôpital Européen Georges Pompidou, Paris, France.

Nathanaël Lapidus (N)

Département de Santé Publique, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France.
Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France.

Aurélien Amiot (A)

Département de Gastro-Entérologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France.

Vincent Audard (V)

Département de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Hôpital Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris AP-HP, Créteil, France.
Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Université Paris Est Créteil UPEC, Equipe 21, Créteil, France.

Khalil El Karoui (K)

Département de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Hôpital Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris AP-HP, Créteil, France.
Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Université Paris Est Créteil UPEC, Equipe 21, Créteil, France.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Techniques d'investigation › Techniques cytologiques › Cytodiagnostic › Biopsie › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques des voies urinaires › Débit de filtration glomérulaire › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Glomérulonéphrite à dépôts d'IgA › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Maladies inflammatoires intestinales › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Appareil urogénital › Voies urinaires › Rein › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études multicentriques comme sujet › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Thérapeutique › Détoxication par sorption › Dialyse rénale › Immunoglobulin A nephropathy in association...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Immunoglobulin A nephropathy in association...