Епидемиология на IgA нефропатията
Keywords:
Имуноглобулин A нефропатия, IgA нефропатия, епидемиология, болестност, заболеваемост
Abstract
IgA нефропатията (ORPHA код: 34145) е рядко, хронично прогресиращо имуно-медиирано бъбречно заболяване и представлява една от основните причини за бъбречна недостатъчност в световен мащаб. Диагнозата на IgAN може да бъде потвърдена само чрез извършването на пункционна бъбречна биопсия, която се явява „златен стандарт“ в диагностиката на този вид бъбречни заболявания. Клиничните прояви на IgAN могат да варират от асимптоматична микроскопска или интермитентна макроскопска хематурия, до бързо прогресиращ гломерулонефрит. Очакваната продължителност на живота при пациентите с IgAN е намалена средно с 10 години и смъртността при тях е два пъти по-висока в сравнение с общата популация.
В рамките на 10–20 години от поставяне на диагнозата близо 50% от пациентите с IgAN развиват терминална бъбречна недостатъчност, налагаща хемодиализа и бъбречна трансплантация. Съществуват доказателства, че епидемиологията, клиничната картина, прогресията на заболяването и дългосрочните резултати при IgAN се различават в различните етнически популации по света. Цел на настоящата публикация е да анализира епидемиологични данни за IgA нефропатията и да направи прогноза за разпространението на това заболяване в България.
References
Orphanet. Immunoglobulin A nephropathy. Availbale from: https://www.orpha.net/consor/cgi-bin/OC_Exp.php?Lng=GB&Expert=34145. Accessed February 2024
European Medicines Agency. EU/3/16/1778: Orphan designation for the treatment of primary IgA nephropathy. Available at: https://www.ema.europa.eu/en/medicines/human/orphan-designations/eu3161778. Accessed January, 2024.
European Medicines Agency. EMA/570757/2022 | EPAR Kinpeygo. Available at: https://www.ema.europa.eu/en/documents/assessment-report/kinpeygo-epar-public-assessment-report_en.pdf. Accessed January, 2024.
European Medicines Agency. EMA/OD/0000066260: Orphan Maintenance Assessment Report, 2022. Available at: https://www.ema.europa.eu/en/documents/orphan-maintenance-report/kinpeygo-epar-orphan-maintenance-assessment-report_en.pdf. Accessed January, 2024.
Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013 Jun 20;368(25):2402-14.
Schena FP, Nistor I. Epidemiology of IgA Nephropathy: A Global Perspective. Semin Nephrol. 2018 Sep;38(5):435-442.
Donadio JV, Grande JP. IgA nephropathy. N Engl J Med. 2002 Sep 5;347(10):738-48.
Penfold RS, Prendecki M, McAdoo S, et al. Primary IgA nephropathy: current challenges and future prospects. Int J Nephrol Renovasc Dis. 2018 Apr 12;11:137-148.
Trimarchi H, Barratt J, Cattran DC, et al; IgAN Classification Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Conference Participants. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017 May;91(5):1014-1021.
Boyd JK, Cheung CK, Molyneux K, et al. An update on the pathogenesis and treatment of IgA nephropathy. Kidney Int. 2012 May;81(9):833-43.
Lai KN. Pathogenesis of IgA nephropathy. Nat Rev Nephrol. 2012 Mar 20;8(5):275-83.
Kiryluk K, Li Y, Scolari F, et al. Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens. Nat Genet. 2014 Nov;46(11):1187-96.
Barratt J, Rovin BH, Cattran D, et al; NefIgArd Study Steering Committee. Why Target the Gut to Treat IgA Nephropathy? Kidney Int Rep. 2020 Aug 20;5(10):1620-1624.
Selvaskandan H, Cheung CK, Muto M, et al. New strategies and perspectives on managing IgA nephropathy. Clin Exp Nephrol. 2019 May;23(5):577-588.
Tomana M, Novak J, Julian BA, et al. Circulating immune complexes in IgA nephropathy consist of IgA1 with galactose-deficient hinge region and antiglycan antibodies. J Clin Invest. 1999 Jul;104(1):73-81.
Smith AC, Molyneux K, Feehally J, et al. O-glycosylation of serum IgA1 antibodies against mucosal and systemic antigens in IgA nephropathy. J Am Soc Nephrol. 2006 Dec;17(12):3520-8.
Suzuki H, Kiryluk K, Novak J, et al. The pathophysiology of IgA nephropathy. J Am Soc Nephrol. 2011 Oct;22(10):1795-803.
Novak J, Julian BA, Mestecky J, et al. Glycosylation of IgA1 and pathogenesis of IgA nephropathy. Semin Immunopathol. 2012 May;34(3):365-82.
Novak J, Rizk D, Takahashi K, et al. New Insights into the Pathogenesis of IgA Nephropathy. Kidney Dis (Basel). 2015 May;1(1):8-18.
Salim A. IgA Nephropathy: Practice Essentials, Pathophysiology, Epidemiology. eMedicine. 2020 Feb 28.
Hastings MC, Bursac Z, Julian BA, et al. Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy. Kidney Int Rep. 2017 Aug 24;3(1):99-104.
Knoop T, Vikse BE, Svarstad E, et al. Mortality in patients with IgA nephropathy. Am J Kidney Dis. 2013 Nov;62(5):883-90.
Фармако-терапевтично ръководство по нефрология и диализа, 2019 г. (Наредба № 13 от 7 ноември 2019 г. за приемане на фармако-терапевтично ръководство по нефрология и диализа, обн. в ДВ, брой 91 от 19.11.2019 г.)
Glassock RJ. Mortality Risk in IgA Nephropathy. J Am Soc Nephrol. 2019 May;30(5):720-722.
Jarrick S, Lundberg S, Welander A, et al. Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study. J Am Soc Nephrol. 2019 May;30(5):866-876.
Schena FP. A retrospective analysis of the natural history of primary IgA nephropathy worldwide. Am J Med. 1990 Aug;89(2):209-15.
Moriyama T, Tanaka K, Iwasaki C, et al. Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan. PLoS One. 2014 Mar 21;9(3):e91756.
Lai KN, Tang SC, Schena FP, et al. IgA nephropathy. Nat Rev Dis Primers. 2016 Feb 11;2:16001.
Willey CJ, Coppo R, Schaefer F, et al. The incidence and prevalence of IgA nephropathy in Europe. Nephrol Dial Transplant. 2023 Sep 29;38(10):2340-2349.
Floege J, Amann K. Primary glomerulonephritides. Lancet. 2016 May 14;387(10032):2036-48.
Kwon CS, Daniele P, Forsythe A, et al. A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy. J Health Econ Outcomes Res. 2021 Sep 1;8(2):36-45.
Mesquita M, Fosso C, Bakoto Sol E, et al. Renal biopsy findings in Belgium: a retrospective single center analysis. Acta Clin Belg. 2011 Mar-Apr;66(2):104-9.
Perkowska-Ptasinska A, Deborska-Materkowska D, Bartczak A, et al. Kidney disease in the elderly: biopsy based data from 14 renal centers in Poland. BMC Nephrol. 2016 Nov 25;17(1):194.
Pattrapornpisut P, Avila-Casado C, Reich HN. IgA Nephropathy: Core Curriculum 2021. Am J Kidney Dis. 2021 Sep;78(3):429-441.
Maixnerova D, Bauerova L, Skibova J, et al. The retrospective analysis of 343 Czech patients with IgA nephropathy--one centre experience. Nephrol Dial Transplant. 2012 Apr;27(4):1492-8.
Zink CM, Ernst S, Riehl J, et al. Trends of renal diseases in Germany: review of a regional renal biopsy database from 1990 to 2013. Clin Kidney J. 2019 Mar 18;12(6):795-800. Erratum in: Clin Kidney J. 2019 Nov 12;14(1):462.
Capusa C, Marti HP, Stefan G, et al. SP138 Comparative analysis of biopsy proven primary glomerulopathies incidence in south east Romania and Norway – A retrospective study over the past two decades. Nephrol Dial Transplant. 2017 May 1;32 (suppl.3): iii151–1.
Gutiérrez E, Praga M, Rivera F, et al; all members of the Spanish Registry of Glomerulonephritis. Changes in the clinical presentation of immunoglobulin A nephropathy: data from the Spanish Registry of Glomerulonephritis. Nephrol Dial Transplant. 2018 Mar 1;33(3):472-477.
Peters B, Stegmayr B, Andersson Y, et al. Increased risk of renal biopsy complications in patients with IgA-nephritis. Clin Exp Nephrol. 2015 Dec;19(6):1135-41.
McQuarrie EP, Mackinnon B, Bell S, et al; Scottish Renal Biopsy Registry. Multiple socioeconomic deprivation and impact on survival in patients with primary glomerulonephritis. Clin Kidney J. 2017 Feb;10(1):49-54.
Ruggajo P, Svarstad E, Leh S, et al. Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy--A Retrospective Registry-Based Cohort Study. PLoS One. 2016 Apr 19;11(4):e0153819.
Taing DT, Vogt B, Mani LY. Characteristics and outcome of IgA nephropathy in Switzerland-a single center perspective (Poster P41). Clinical nephrology / hypertension / mineral / electrolytes. 2018;148:24S.
Russo E, Verzola D, Salvidio G, et al. Long-term blood pressure behavior and progression to end-stage renal disease in patients with immunoglobulin A nephropathy: a single-center observational study in Italy. J Hypertens. 2020 May;38(5):925-935.
Cambier A, Rabant M, El Karoui K, et al. Clinical and histological differences between adults and children in new onset IgA nephropathy. Pediatr Nephrol. 2020 Oct;35(10):1897-1905.
Tesar V, Troyanov S, Bellur S, et al; VALIGA study of the ERA-EDTA Immunonephrology Working Group. Corticosteroids in IgA Nephropathy: A Retrospective Analysis from the VALIGA Study. J Am Soc Nephrol. 2015 Sep;26(9):2248-58.
Deng W, Tan X, Zhou Q, et al. Gender-related differences in clinicopathological characteristics and renal outcomes of Chinese patients with IgA nephropathy. BMC Nephrol. 2018 Feb 7;19(1):31.
Fellström BC, Barratt J, Cook H, et al; NEFIGAN Trial Investigators. Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial. Lancet. 2017 May 27;389(10084):2117-2127.
Moranne O, Watier L, Rossert J, et al; GN-Progress Study Group. Primary glomerulonephritis: an update on renal survival and determinants of progression. QJM. 2008 Mar;101(3):215-24.
Нефрология, под редакцията на Проф. Е. Паскалев. 2015 г., Изд. Булгарресурс
Тилкиян Е, Кумчев Е, Минкова В. Имуноглобулин А нефропатия при пациенти в напреднала и старческа възраст – диагноза, терапия и клинични резултати. Съвременна Медицина, бр.2, 2017, стр.12-15
Маринова И, Златков Б, Димитров М и съавт. IgA гломерулонефрит при бъбречно трансплантирани пациенти. Нефрология, диализа и трансплантация, 26, 2020, N 1.
Маринова И, Златков Б, Филипов Ж и съавт. IgA гломерулонефрит, GP News, Брой 10, 2021
Kostadinova I, Lyubomirova M, Bogov B, et al. WCN23-1112 Evaluation of novel biomarkers for IgA nephropathy in the Bulgarian population. Kidney Int Rep. 2023 Mar 1; 8 (3, Supplement):S230.
Михайлов М. Проучвания върху съвременните характеристики на огнищната и сегментна гломерулна склероза. Автореферат на дисертационен труд за присъждане на ОНС „Доктор“. ВМА – София, 2023.
Робева Р, Йорданов М. Гломерулни увреждания при боли с псориазис, Медицински преглед, 47, 2011, N 4
Кумчев Е, Тилкиян Е, Минкова В и съавт. Анти-гломерулобазалномембранен бързопрогресиращ гломерулонефрит с IgA линейни отлагания. Нефрология, Диализа, Трансплантация. 2016, 4, 30-34.
Статистически справочник "Преброяване 2021", Национален статистически институт, София, България, публикуван на 15.11.2023 г.
Rodrigues JC, Haas M, Reich HN. IgA Nephropathy. Clin J Am Soc Nephrol. 2017 Apr 3;12(4):677-686.
Thompson A, Carroll K, A Inker L, et al. Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy. Clin J Am Soc Nephrol. 2019 Mar 7;14(3):469-481.
Laurens W, Deleersnijder D, Dendooven A, et al; FCGG collaborative group. Epidemiology of native kidney disease in Flanders: results from the FCGG kidney biopsy registry. Clin Kidney J. 2022 Jan 29;15(7):1361-1372.
European Medicines Agency. EU/3/16/1778: Orphan designation for the treatment of primary IgA nephropathy. Available at: https://www.ema.europa.eu/en/medicines/human/orphan-designations/eu3161778. Accessed January, 2024.
European Medicines Agency. EMA/570757/2022 | EPAR Kinpeygo. Available at: https://www.ema.europa.eu/en/documents/assessment-report/kinpeygo-epar-public-assessment-report_en.pdf. Accessed January, 2024.
European Medicines Agency. EMA/OD/0000066260: Orphan Maintenance Assessment Report, 2022. Available at: https://www.ema.europa.eu/en/documents/orphan-maintenance-report/kinpeygo-epar-orphan-maintenance-assessment-report_en.pdf. Accessed January, 2024.
Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013 Jun 20;368(25):2402-14.
Schena FP, Nistor I. Epidemiology of IgA Nephropathy: A Global Perspective. Semin Nephrol. 2018 Sep;38(5):435-442.
Donadio JV, Grande JP. IgA nephropathy. N Engl J Med. 2002 Sep 5;347(10):738-48.
Penfold RS, Prendecki M, McAdoo S, et al. Primary IgA nephropathy: current challenges and future prospects. Int J Nephrol Renovasc Dis. 2018 Apr 12;11:137-148.
Trimarchi H, Barratt J, Cattran DC, et al; IgAN Classification Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Conference Participants. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017 May;91(5):1014-1021.
Boyd JK, Cheung CK, Molyneux K, et al. An update on the pathogenesis and treatment of IgA nephropathy. Kidney Int. 2012 May;81(9):833-43.
Lai KN. Pathogenesis of IgA nephropathy. Nat Rev Nephrol. 2012 Mar 20;8(5):275-83.
Kiryluk K, Li Y, Scolari F, et al. Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens. Nat Genet. 2014 Nov;46(11):1187-96.
Barratt J, Rovin BH, Cattran D, et al; NefIgArd Study Steering Committee. Why Target the Gut to Treat IgA Nephropathy? Kidney Int Rep. 2020 Aug 20;5(10):1620-1624.
Selvaskandan H, Cheung CK, Muto M, et al. New strategies and perspectives on managing IgA nephropathy. Clin Exp Nephrol. 2019 May;23(5):577-588.
Tomana M, Novak J, Julian BA, et al. Circulating immune complexes in IgA nephropathy consist of IgA1 with galactose-deficient hinge region and antiglycan antibodies. J Clin Invest. 1999 Jul;104(1):73-81.
Smith AC, Molyneux K, Feehally J, et al. O-glycosylation of serum IgA1 antibodies against mucosal and systemic antigens in IgA nephropathy. J Am Soc Nephrol. 2006 Dec;17(12):3520-8.
Suzuki H, Kiryluk K, Novak J, et al. The pathophysiology of IgA nephropathy. J Am Soc Nephrol. 2011 Oct;22(10):1795-803.
Novak J, Julian BA, Mestecky J, et al. Glycosylation of IgA1 and pathogenesis of IgA nephropathy. Semin Immunopathol. 2012 May;34(3):365-82.
Novak J, Rizk D, Takahashi K, et al. New Insights into the Pathogenesis of IgA Nephropathy. Kidney Dis (Basel). 2015 May;1(1):8-18.
Salim A. IgA Nephropathy: Practice Essentials, Pathophysiology, Epidemiology. eMedicine. 2020 Feb 28.
Hastings MC, Bursac Z, Julian BA, et al. Life Expectancy for Patients From the Southeastern United States With IgA Nephropathy. Kidney Int Rep. 2017 Aug 24;3(1):99-104.
Knoop T, Vikse BE, Svarstad E, et al. Mortality in patients with IgA nephropathy. Am J Kidney Dis. 2013 Nov;62(5):883-90.
Фармако-терапевтично ръководство по нефрология и диализа, 2019 г. (Наредба № 13 от 7 ноември 2019 г. за приемане на фармако-терапевтично ръководство по нефрология и диализа, обн. в ДВ, брой 91 от 19.11.2019 г.)
Glassock RJ. Mortality Risk in IgA Nephropathy. J Am Soc Nephrol. 2019 May;30(5):720-722.
Jarrick S, Lundberg S, Welander A, et al. Mortality in IgA Nephropathy: A Nationwide Population-Based Cohort Study. J Am Soc Nephrol. 2019 May;30(5):866-876.
Schena FP. A retrospective analysis of the natural history of primary IgA nephropathy worldwide. Am J Med. 1990 Aug;89(2):209-15.
Moriyama T, Tanaka K, Iwasaki C, et al. Prognosis in IgA nephropathy: 30-year analysis of 1,012 patients at a single center in Japan. PLoS One. 2014 Mar 21;9(3):e91756.
Lai KN, Tang SC, Schena FP, et al. IgA nephropathy. Nat Rev Dis Primers. 2016 Feb 11;2:16001.
Willey CJ, Coppo R, Schaefer F, et al. The incidence and prevalence of IgA nephropathy in Europe. Nephrol Dial Transplant. 2023 Sep 29;38(10):2340-2349.
Floege J, Amann K. Primary glomerulonephritides. Lancet. 2016 May 14;387(10032):2036-48.
Kwon CS, Daniele P, Forsythe A, et al. A Systematic Literature Review of the Epidemiology, Health-Related Quality of Life Impact, and Economic Burden of Immunoglobulin A Nephropathy. J Health Econ Outcomes Res. 2021 Sep 1;8(2):36-45.
Mesquita M, Fosso C, Bakoto Sol E, et al. Renal biopsy findings in Belgium: a retrospective single center analysis. Acta Clin Belg. 2011 Mar-Apr;66(2):104-9.
Perkowska-Ptasinska A, Deborska-Materkowska D, Bartczak A, et al. Kidney disease in the elderly: biopsy based data from 14 renal centers in Poland. BMC Nephrol. 2016 Nov 25;17(1):194.
Pattrapornpisut P, Avila-Casado C, Reich HN. IgA Nephropathy: Core Curriculum 2021. Am J Kidney Dis. 2021 Sep;78(3):429-441.
Maixnerova D, Bauerova L, Skibova J, et al. The retrospective analysis of 343 Czech patients with IgA nephropathy--one centre experience. Nephrol Dial Transplant. 2012 Apr;27(4):1492-8.
Zink CM, Ernst S, Riehl J, et al. Trends of renal diseases in Germany: review of a regional renal biopsy database from 1990 to 2013. Clin Kidney J. 2019 Mar 18;12(6):795-800. Erratum in: Clin Kidney J. 2019 Nov 12;14(1):462.
Capusa C, Marti HP, Stefan G, et al. SP138 Comparative analysis of biopsy proven primary glomerulopathies incidence in south east Romania and Norway – A retrospective study over the past two decades. Nephrol Dial Transplant. 2017 May 1;32 (suppl.3): iii151–1.
Gutiérrez E, Praga M, Rivera F, et al; all members of the Spanish Registry of Glomerulonephritis. Changes in the clinical presentation of immunoglobulin A nephropathy: data from the Spanish Registry of Glomerulonephritis. Nephrol Dial Transplant. 2018 Mar 1;33(3):472-477.
Peters B, Stegmayr B, Andersson Y, et al. Increased risk of renal biopsy complications in patients with IgA-nephritis. Clin Exp Nephrol. 2015 Dec;19(6):1135-41.
McQuarrie EP, Mackinnon B, Bell S, et al; Scottish Renal Biopsy Registry. Multiple socioeconomic deprivation and impact on survival in patients with primary glomerulonephritis. Clin Kidney J. 2017 Feb;10(1):49-54.
Ruggajo P, Svarstad E, Leh S, et al. Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy--A Retrospective Registry-Based Cohort Study. PLoS One. 2016 Apr 19;11(4):e0153819.
Taing DT, Vogt B, Mani LY. Characteristics and outcome of IgA nephropathy in Switzerland-a single center perspective (Poster P41). Clinical nephrology / hypertension / mineral / electrolytes. 2018;148:24S.
Russo E, Verzola D, Salvidio G, et al. Long-term blood pressure behavior and progression to end-stage renal disease in patients with immunoglobulin A nephropathy: a single-center observational study in Italy. J Hypertens. 2020 May;38(5):925-935.
Cambier A, Rabant M, El Karoui K, et al. Clinical and histological differences between adults and children in new onset IgA nephropathy. Pediatr Nephrol. 2020 Oct;35(10):1897-1905.
Tesar V, Troyanov S, Bellur S, et al; VALIGA study of the ERA-EDTA Immunonephrology Working Group. Corticosteroids in IgA Nephropathy: A Retrospective Analysis from the VALIGA Study. J Am Soc Nephrol. 2015 Sep;26(9):2248-58.
Deng W, Tan X, Zhou Q, et al. Gender-related differences in clinicopathological characteristics and renal outcomes of Chinese patients with IgA nephropathy. BMC Nephrol. 2018 Feb 7;19(1):31.
Fellström BC, Barratt J, Cook H, et al; NEFIGAN Trial Investigators. Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial. Lancet. 2017 May 27;389(10084):2117-2127.
Moranne O, Watier L, Rossert J, et al; GN-Progress Study Group. Primary glomerulonephritis: an update on renal survival and determinants of progression. QJM. 2008 Mar;101(3):215-24.
Нефрология, под редакцията на Проф. Е. Паскалев. 2015 г., Изд. Булгарресурс
Тилкиян Е, Кумчев Е, Минкова В. Имуноглобулин А нефропатия при пациенти в напреднала и старческа възраст – диагноза, терапия и клинични резултати. Съвременна Медицина, бр.2, 2017, стр.12-15
Маринова И, Златков Б, Димитров М и съавт. IgA гломерулонефрит при бъбречно трансплантирани пациенти. Нефрология, диализа и трансплантация, 26, 2020, N 1.
Маринова И, Златков Б, Филипов Ж и съавт. IgA гломерулонефрит, GP News, Брой 10, 2021
Kostadinova I, Lyubomirova M, Bogov B, et al. WCN23-1112 Evaluation of novel biomarkers for IgA nephropathy in the Bulgarian population. Kidney Int Rep. 2023 Mar 1; 8 (3, Supplement):S230.
Михайлов М. Проучвания върху съвременните характеристики на огнищната и сегментна гломерулна склероза. Автореферат на дисертационен труд за присъждане на ОНС „Доктор“. ВМА – София, 2023.
Робева Р, Йорданов М. Гломерулни увреждания при боли с псориазис, Медицински преглед, 47, 2011, N 4
Кумчев Е, Тилкиян Е, Минкова В и съавт. Анти-гломерулобазалномембранен бързопрогресиращ гломерулонефрит с IgA линейни отлагания. Нефрология, Диализа, Трансплантация. 2016, 4, 30-34.
Статистически справочник "Преброяване 2021", Национален статистически институт, София, България, публикуван на 15.11.2023 г.
Rodrigues JC, Haas M, Reich HN. IgA Nephropathy. Clin J Am Soc Nephrol. 2017 Apr 3;12(4):677-686.
Thompson A, Carroll K, A Inker L, et al. Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy. Clin J Am Soc Nephrol. 2019 Mar 7;14(3):469-481.
Laurens W, Deleersnijder D, Dendooven A, et al; FCGG collaborative group. Epidemiology of native kidney disease in Flanders: results from the FCGG kidney biopsy registry. Clin Kidney J. 2022 Jan 29;15(7):1361-1372.
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2024-03-14
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Митова Е, Ананиев Ю, Стефанов Г. Епидемиология на IgA нефропатията. Редки болести и лекарства сираци [Internet]. 2024Mar.14 [cited 2024Nov.24];15(1):3-11. Available from: https://journal.raredis.org/index.php/RBLS/article/view/192
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