NDT Advance Access originally published online on March 7, 2006
Nephrology Dialysis Transplantation 2006 21(7):1876-1882; doi:10.1093/ndt/gfl062
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Clinical Nephrology
Vascular diseases and their risk factors in IgA nephropathy
1 Medical School, University of Tampere, 2 Department of Internal Medicine, Tampere University Hospital, 3 Division of Pathology, HUSLAB, Helsinki University Hospital and 4 National Public Health Institute, Department of Health and Functional Capacity, Helsinki, Finland
Correspondence and offprint requests to: Jukka Mustonen, MD, PhD, Medical School, University of Tampere, FIN-33014, Finland. Email: jukka.mustonen{at}uta.fi
Background. Many studies have focused on risk factors for renal insufficiency in IgA nephropathy (IgAN). We recently found metabolic factors, especially uric acid, to predict progression and marked histopathological lesions in IgAN. Since vascular diseases (VDs), in addition to renal insufficiency, affect the overall survival of IgAN patients, we studied the occurrence of and risk factors underlying VDs in IgAN.
Methods. In this study, VDs here comprised the presence of coronary heart disease (CHD) and/or cerebrovascular disease (CeVD). We correlated clinical, metabolic and histopathological findings with the occurrence of VDs in 221 adult patients with IgAN. Seven histopathological parameters were semiquantitatively graded. Logistic regression analysis was used to evaluate independent predictors of VDs in these patients. The occurrence of VDs in IgAN patients 
30 years of age was studied and compared with that in the general population drawn from the same area.
Results. VDs were notably common in IgAN patients. Patients with IgAN had significantly more frequent VDs, CHD and CeVD than the general population (P<0.01 to <0.001). Of 30 years of age IgAN patients, 25% had some VD at the end of follow-up, while only 9% of the general population had VDs [odds ratio, OR 4.6 (2.2–9.4)]. Old age, male gender, hypertension, proteinuria, renal insufficiency, hyperuricaemia, hypertriglyceridaemia, diabetes, smoking and high body mass index correlated with the occurrence of VDs in univariate analysis. In all patients initial renal insufficiency and smoking were independently associated with some VD, male gender with CHD and hypertension with CeVD. In the multivariate analysis model including patients with initially normal renal function, male gender was independently associated with some VD, and hypertriglyceridaemia with CHD.
Conclusion. VDs, especially CeVD, would seem to be particularly common in patients with IgAN. Patients with progressive renal disease run a significantly elevated risk of developing VD. Many previously known risk factors for VD were also associated with the occurrence of some VD in the present study. Vascular changes seen in renal biopsy in patients with IgAN signify an elevated risk of VDs.
Keywords: cerebrovascular disease; coronary heart disease; glomerulonephritis; hyperlipidaemia; IgA nephropathy; serum uric acid
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S. R. Orth and S. I. Hallan Smoking: A Risk Factor for Progression of Chronic Kidney Disease and for Cardiovascular Morbidity and Mortality in Renal Patients Absence of Evidence or Evidence of Absence? Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 226 - 236. [Abstract] [Full Text] [PDF]
|
|