Many patients care about the prognosis of IgA Nephropathy and they wonder whether IgA Nephropathy will lead to renal failure. IgA Nephropathy, mesangial proliferative IgA Nephropathy as its full name, refers in particular to the primary IgA Nephropathy, characterized by deposition of IgA (mainly) and other immune complex in mesangial area. It has various manifestations and does not have fixed features in histology.
The progression of IgA Nephropathy is relatively slow in the early stage, but there will be a period that this renal function declines sharply and it develops into renal failure. So we need to have a good learning of the progression of IgA Nephropathy.
According to pathological changes, it can be divided into five stages.
1. Glomeruli are normal under the light microscopy and only a few parts appear to have slight broadening of mesangial area, with or without mesangial cells' proliferation.
2. Level II. (Mild change). More than half of the glomeruli appear normal and only a small part are found to have changes like mesangial cells' proliferation, glomerular sclerosis and adhension, etc. and crescents which is rarely seen.
3. Level III. (Focal Segmental Glomerulonephritis). This level is characterized by diffuse hyperplasia of mesangial cells, broadening of mesangial area, focal segmental pathological change and occasional adhension and crescents. Renal interstitium has slight pathological change, showing edema, focal inflammatory cell' infiltration.
4. Level IV. (Diffuse Mesangial Proliferative Glomerulonephritis). Almost all glomeruli can be found to have diffuse proliferative mesangial cells, obviously broadened mesangial area, glomerulosclerosis and failed glomeruli can usually be seen. Over half of the glomeruli appear to have both cytoadherence and crescent. Tubules-interstitial have severe pathological change, tubular atrophies obviously and a large amount of inflammatory cell infiltration can be seen from interstitium.
