CHRONIC RENAL-INSUFFICIENCY AFTER AN EPISODE OF MACROSCOPIC HEMATURIAIN IGA NEPHROPATHY

Several cases of acute renal failure associated with episodes of macro scopic hematuria (EMH) in IgA nephropathy (IgAN) have been reported; i n every case renal function returned to normal. We report 2 cases with previous normal renal function that developed acute renal failure dur ing EMH of 17 and 30 days duration, respectively. Renal biopsies showe d mesangial proliferation with IgA deposits, crescents in 10-15% of gl omeruli and a marked tubular necrosis with red blood cell casts obstru cting the lumen in 30-45% of tubules. Although renal function improved after EMH cessation, it did not recover previous normal values. Thus, EMH can produce permanent loss of renal function in patients with IgA N.