Frequency and Morphology of IgA Nephropathy in Multiple Centers Lahore

Methods: One hundred and thirty two consecutive patients of nephrotic and nephritic syndrome, both children and adult, were included in the study. After baseline investigations and serum IgA level, 33 patients having clinical suspicion of IgA nephropathy and 1 patient of Henoch Schonlein purpura nephritis were admitted and renal biopsies were taken by well trained nephrologists after consent from the patients and/ or parents of the patient in care of a child. These cases were selected from Sheikh Zayed Hospital, Children Hospital, Services Hospital, Fatima Memorial Hospital and Jinnah Hospital Lahore. Results: Among these 34 renal biopsies, 23 (67.65%) were males and 11(32.35%) were females. The minimum age at biopsy was 2 years and maximum was 73 years, mean±S.D of age was 28.18±19.62. The minimum serum creatinine was 0.60 mg/dl and maximum serum creatinine was 12.80 mg/dl with a mean + S.D serum creatinine being 2.92±3.14mg/dl. Serum IgA level was performed in all the 34 patients out of which 20 (58.82%) showed raised level while 14(41.17%) cases showed normal IgA levels. Among 34 clinically suspected of IgA nephropathy, 17 cases turned out to be of IgA nephropathy after morphological and IF studies. The age range for IgA nephropathy patients was 4 to 73 years with a mean age of 31.41 years and female to male ratio was 1:1.83. IgA nephropathy patients presented with microscopic haematuria (61.5%), macroscopic haematuria (38.4%), proteinuria of less than 2g/dl (35.4%), proteinuria of more than 2g/dl (58.3%) and hypertension (41.2%) mainly. Serum IgA level was raised in 76.5% patients of IgA nephropathy. According to Hass Classification in this study, highest percentage (29.4%) turned out to be of focal mesangioproliferative GN and advanced ch GN. Conclusion: Diagnosis of IgA nephropathy cannot be made clinically as it has not proven a reliable method so renal biopsy in addition to the H&E and histochemistry should be examined using immunofluorescence that is mandatory for the correct diagnosis of IgA nephropathy.