[Indices of progression of IgA glomerulopathy].

A retrospective and prospective study of 58 patients with IgA glomerulonephritis was undertaken between the 1st April 1975 and the 1st May 1982, to determine the clinical, biological and histological features associated with the onset of renal failure and a poor prognosis. At the end of this study the patients were classified into 4 groups according to the clinical stage of their disease: a) normal, b) minor urinary abnormalities, c) active disease and d) terminal renal failure. The renal biopsies were reviewed and an index of histological activity defined. The significant features associated with progression of the disease to renal failure were: persistent proteinuria, a transient nephrotic syndrome, hypertension, diffuse proliferative glomerular changes with epithelial crescent formation, tubulo-interstitial changes and vascular lesions on renal biopsy. When confronted with the clinical outcome, the histological results of the first renal biopsy performed when the disease was first diagnosed and quantified in an index of activity, had a good predictive value.