Primary immunoglobulin A nephropathy through the 'retrospectroscope'

OBJECTIVE: To review pathological approaches to the diagnosis and prognosis of primary immunoglobulin A nephropathy. DATA SOURCES: Medline and non-Medline literature search (1966-1999) and personal experience. STUDY SELECTION: The following key words were used: IgA nephropathy, pathology, grading. DATA EXTRACTION: Data were extracted and analysed independently by the authors. DATA SYNTHESIS: Primary immunoglobulin A nephropathy is the most common glomerular disease worldwide and this also holds true in Hong Kong, where it represents the most common condition encountered in diagnostic renal biopsy examinations. This type of chronic nephropathy currently has no effective curable therapy, and in a significant proportion of patients, it progress to end-stage renal disease. Supportive treatment is very important, because it may alter the natural course and slow down the progression of this nephritis. CONCLUSION: Pathological grading of immunoglobulin A nephropathy currently represents the most useful method to appraise the renal outcome.