Francesco Paolo Schena
University of Bari, Italy
Title: The global burden of Immunoglobulin a nephropathy. A message for general practitioners and nephrologists.
Biography
Biography: Francesco Paolo Schena
Abstract
Immunoglobulin A nephropathy (IgAN) or Berger's disease is the most common primary glomerulonephritis worldwide, but there are large variations in geographical distribution. Recently, we have investigated on the prevalence of the disease for analyzing factors responsible for this difference.
We have observed that i) systematic mass screenings of urine in populations, as occurring in some Asian countries (Japan, Korea and Singapore), are not a common practice in the Western countries; ii) general practitioners and healthcare professionals underestimate the persistent microscopic hematuria and/or mild proteinuria in apparently health individuals; this approach causes late referral to nephrologist; iii) there are different indications for the kidney biopsy adopted by nephrologists in individuals with persistent urinary abnormalities.
Aim of this lecture is to stimulate the medical community to go beyond these barriers because in all countries IgAN is potentially the largest diffuse kidney disease with annual incidence of ˜40˜50 cases per million population. This very common disease depicts two important aspects: i) IgAN may have a heavy economic impact on the National Healthcare Systems because mainly children, youngsters and adults in 2nd and 3rd decade of life develop the disease; ii) 40% of these patients arrive in ESKD by 20 years from the biopsy-proven diagnosis when they are in a productive working time of their life.
A great effort should be done for the early diagnosis of the disease in individuals who manifest persistent microhematuria and/or mild proteinuria. It is necessary to introduce more stringent indications for kidney biopsy. This preventive approach followed by early therapy may reduce the global burden of end-stage kidney disease caused by IgAN.
Key words: IgA nephropathy, Berger's disease, microscopic hematuria, gross hematuria, kidney biopsy.