Dr Alastair Richards1, Dr JANAK DE ZOYSA1,2
1WAITEMATA DISTRICT HEALTH BOARD, AUCKLAND, NEW ZEALAND, 2DEPARTMENT OF MEDICINE, UNIVERSITY OF AUCKLAND, AUCKLAND, NEW ZEALAND
Aim: To improve the understanding of the incidence, clinical features, therapies, and outcomes for New Zealand (NZ) Māori and Pasifika populations with Immunoglobulin A Nephropathy (IgAN).
Background: IgAN is the most common glomerulonephritis and can lead to chronic kidney disease or end stage kidney disease. Overseas studies have identified that for IgAN ethnic differences exist. There is a paucity of studies within NZ assessing the incidence, clinical features, therapies, and outcomes of IgAN, and scant evidence looking at outcomes in Māori and Pasifika populations in NZ.
Methods: A biopsy database identified all patients with biopsy-proven IgA Nephropathy within three District Health Boards within the Auckland and Northland region between 01/01/2003 and 31/12/2018. Data was collected from electronic records.
Results: A total of 167 patients with IgAN were included over a 16-year period. The incidence was 0.9 per 100,000 adults per year. 55.7% of patients were males. There were 44.3% NZ European, 10.8% NZ Māori, and 7.8% Pasifika. The mean weight was 81.1kg with BMI 28.8. Mean blood pressure was 131mmHg systolic and 79mmHg diastolic with mean arterial pressure of 96mmHg. Patients used a mean of two anti-hypertensive agents (range 0-4). Regarding therapies, 82.6% were on renin angiotensin system (RAS) blockade, 29.9% on corticosteroids, 6% on immunosuppressants, 12% on omega-3 fatty acids, and 36.5% on statins.
Conclusion: This is one of the largest cohorts of biopsy-proven IgAN with 18 cases in Māori and 13 cases in Pasifika. There was no statistically significant difference in weight, blood pressure, or anti-hypertensive medications between Māori compared to NZ European. Māori had fewer statins (p=0.04) and Pasifika had lower blood pressure (systolic p=0.001, diastolic p=0.03) and fewer anti-hypertensive medications (p=0.004).
Biography:
Dr Alastair Richards is a second year nephrology advanced trainee working within the Auckland Region. He has an interest in glomerular diseases and hypertension.