A 20-year follow-up study of identical twin sisters with immunoglobulin A nephropathy

Masahiro Okabe; Nobuo Tsuboi; Hiroyuki Ueda; Erika Hishida; Yoichi Miyazaki; Takashi Yokoo

doi:10.1093/ckj/sfae073

A 20-year follow-up study of identical twin sisters with immunoglobulin A nephropathy

Clin Kidney J. 2024 Mar 22;17(4):sfae073. doi: 10.1093/ckj/sfae073. eCollection 2024 Apr.

Authors

Masahiro Okabe^{1

2}, Nobuo Tsuboi¹, Hiroyuki Ueda¹, Erika Hishida³, Yoichi Miyazaki^{1

2}, Takashi Yokoo¹

Affiliations

¹ Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
² Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine Daisan Hospital, Tokyo, Japan.
³ Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Japan.

Abstract

Immunoglobulin A nephropathy (IgAN) is characterized by diverse clinicopathological phenotypes. Herein we present a follow-up study of previously reported identical twin sisters with IgAN. The older sister exhibited more severe kidney histopathology and proteinuria and a lower birthweight than did her younger sister, and only the older sister experienced two childbirths. These raised concerns regarding her kidney outcomes. However, with timely multidisciplinary treatments, the older sister's kidney function remained preserved after 20 years of IgAN history. Our findings indicate the significant contribution of environmental/epigenetic factors to IgAN progression and the need for tailored medical care corresponding to life events.

Keywords: IgA nephropathy; chronic kidney disease; life event; monozygotic; twins.

Publication types

Case Reports