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PROGRESSION FACTORS OF CHRONIC GLOMERULONEPHRITIS WITH ISOLATED URINARY SYNDROME

https://doi.org/10.24884/1561-6274-2008-12-1-29-35

Abstract

THE AIM of the investigation was to study the course of chronic glomerulonephritis (CGN) with isolated urinary syndrome (IUS) and to detect the  most substantial  factors  having a  negative  influence  on the  disease  prognosis. PATIENTS AND METHODS. The course of CGN with IUS was retrospectively assessed in 123 women and 174 men aged from 15 to 77 years (32.72±0.82). Duration of the disease of the patients under investigation was from  1  year to 42 years (11.16±0.42 years) and did  not reliably differ in women  (11.92±0.67) from that in  men  (10.61±0.53).  The date when persistant proteinuria and/or hematuria was registered  is taken  for the  beginning  of the  disease.  RESULTS. Two multifactorial models were formed on the basis of the investigations performed. The first model is a clinico-laboratory model for specification of ihe prognostic value of such factors as age at the moment of the disease beginning, exacerbations and acute nephritic syndrome ans in anamnesis,  intensity of proteinuria and hematuria. The second is a laboratory model. It dealt with the influence of the level of immunoglobulins IgA, IgM, IgG and complement titer on kidney survival. The final variant of the clinico-laboratory model (p=0.000) included such factors as the age more than 35 years (p=0.010), the presence of exacerbations in anamnesis (p=0.073), the presence of ANS (p=0.074) and the proteinuria level (p=0.000). The final variant of the laboratory model (p=0.000) included such indices as higher level of IgA (p=0.000) and IgM (p=0.069). CONCLUSION. The data obtained suggest that activity of the inflammatory process in CGN patients with IUS is prognostically unfavorable. The data of the unfavorable prognostic influence of mild and even minimal proteinuria show that the strategy of managing CGN patients with IUS may be considered as debatable and requiring further analysis of indications to using immunosuppressive therapy in this category of patients.

About the Authors

V. L. Duman
Уральская государственная медицинская академия, Екатеринбург; Московская медицинская академия им. И.М. Сеченова, Москва
Russian Federation


E. M. Shilov
Уральская государственная медицинская академия, Екатеринбург; Московская медицинская академия им. И.М. Сеченова, Москва
Russian Federation


N. Yu. Batanina
Уральская государственная медицинская академия, Екатеринбург; Московская медицинская академия им. И.М. Сеченова, Москва
Russian Federation


N. B. Krokhina
Уральская государственная медицинская академия, Екатеринбург; Московская медицинская академия им. И.М. Сеченова, Москва
Russian Federation


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Review

For citations:


Duman V.L., Shilov E.M., Batanina N.Yu., Krokhina N.B. PROGRESSION FACTORS OF CHRONIC GLOMERULONEPHRITIS WITH ISOLATED URINARY SYNDROME. Nephrology (Saint-Petersburg). 2008;12(1):29-35. (In Russ.) https://doi.org/10.24884/1561-6274-2008-12-1-29-35

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ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)