Prognostic indices and therapy in IgA nephropathy: toward a solution.

IgA nephropathy is the primary renal disease with the greatest impact on services. The paucity of trials with high evidence-based standards gives emphasis to issues of the rationalization of therapies. Now that certain treatments are increasingly accepted and others under evaluation, reliable discriminatory tests are essential to define and select patients at high risk of progression before irreversible loss of renal tissue, while avoiding drug exposure in others.

Quantitative appraisal of treatment options for IgA nephropathy.

IgA nephropathy has an impact on renal health care costs worldwide. The paucity of good clinical trials highlights the uncertainty in determining best treatment and for how long. Ongoing debate still raises questions on why opinions vary but may suggest that current data are not fully understood.

Mesangial autoantigens in IgA nephropathy: matrix synthesis and localization.

Primary IgA nephropathy, a chronic nephritis with variable prognosis, is characterized by mesangial immunoglobulin A, frequently with codeposition of other immunoglobulin isotypes and complement components accompanying matrix expansion typically preceding glomerular scarring. Glomerular immunoglobulin G, when present, is localized to the mesangial periphery found variably in repeat biopsies. IgG anti-mesangial cell autoantibodies (IgG-MESCA) in sera of patients with IgA nephropathy, specific by F(ab')(2) binding to 48- and 55-kD autoantigen(s) could account for these deposits, but their in vivo localization, and the functional role in promoting scarring is unknown.

Henoch Schönlein purpura with nephritis in adults: adverse prognostic indicators in a UK population.

Background: Henoch Schönlein purpura with nephritis (HSN) in adults may cause severe organ injury, but its rarity has contributed to a lack of data.

Aim: To evaluate clinical outcomes and risk factors in adult HSN patients.

Design: Retrospective analysis.