Iga nephropathy is the most common form of primary glomerulonephritis in the developed world and it is also an important cause of end stage renal failure. Prevalence seems much higher in Asia, Australia, Finland and south Europe. In UK, Canada and US, the prevalence rate is much lower.
Normally, immunofluorescent tagging of antibodies to detect antigens in tissues and percutaneous renal biopsy, along the discovery of an new immunoglobulin present in serum and in tissue secretions all collided to prepare the way for the seminal observations.
It is now fully recognized that IgA Nephropathy is not always a benign disease. It has a cumulative renal survival of 89% after five years, 81% after ten years and 65% after 20 years. The unfavorable long term prognostic indices are proteinuria of more than 1g/day, hypertension, glomerulosclerosis exceeding 20%, presence pf crescents, and medial hyperplasia of blood vessels on renal biopsy. Especially, patients who have uncontrolled hypertension seems to have a more rapid clinical course progressing to end stage within a few years. A small subset of patients with heavy proteinuria behaves clinically like minimal change disease. Their proteinuria responds to steroid and this subset was recognized as an overlapping syndrome if IgA Nephropathy and lipoid nephrosis. Otherwise, sever nephrotic range proteinuria is not common in IgA Nephropathy, but nephrotic-range proteinuria in the absence of minimal change disease is associated with poor prognosis.
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