Clinical and histological risk factors for progression of IgA nephropathy: an update in children, young and adult patients.

The identification of risk factors conditioning the progression of immunoglobulin (Ig)A nephropathy (IgAN) is needed due to the variability of the outcome of this renal disease, which ranges from remission or indolent course to progressive slow loss of renal function or rapidly evolving chronic renal failure. Based on the supposed individual risk of progression, the therapy is modulated from renin-angiotensin inhibitors to corticosteroids, alone or associated with other powerful but potentially harmful immunosuppressors. Over the last 20 years, several studies have produced great advances in the field of biomarkers for detecting risk factors that play a role in the progression of IgAN. This review will focus on the clinical and histological risk factors which have been detected and validated by the majority of the studies and which may presently be considered of value for prognostication of outcome in patients with IgAN, driving the individual treatment choice.