Prognosis
IgAN has traditionally been considered a benign disease. However, it is now well recognised that a significant proportion of patients will develop slowly progressive chronic kidney disease and hypertension, have an increased cardiovascular risk profile, and are at risk of end-stage kidney disease (ESKD). Approximately 30% of patients with IgAN will progress to ESKD in 10 to 25 years from diagnosis.[92][93] A novel IgAN risk prediction tool published by the International IgA Nephropathy Network incorporates 12 parameters (including the MEST histologic score and clinical variables measured at the time of kidney biopsy) to calculate the risk of progression to a 50% decline in estimated glomerular filtration rate or ESKD up to 5 years from diagnosis.[94] The tool is available as an online calculator.
Patients who develop ESKD should be considered for kidney transplantation. One fourth to one half of transplant recipients develop recurrence of the disease.[37][36][95]
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