Clinicopathologic features and prognosis of childhood IgA nephropathy.
10.3345/kjp.2007.50.2.170
- Author:
Sung Il WOO
1
;
Keun Wook BAE
;
Joo Hoon LEE
;
Young Seo PARK
;
Yong Mee CHO
Author Information
1. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yspark@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Glomerulonephritis;
IGA;
Children;
Prognosis
- MeSH:
Biopsy;
Child;
Classification;
Follow-Up Studies;
Glomerulonephritis;
Glomerulonephritis, IGA*;
Hematuria;
Humans;
Hypertension;
Immunoglobulin A*;
Kidney Failure, Chronic;
Prognosis*;
Proteinuria;
Sclerosis
- From:Korean Journal of Pediatrics
2007;50(2):170-177
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Clinicopathological features were investigated to clarify the outcome and prognostic indicators for patients with IgA nephropathy in Korean children. METHODS: We reviewed the outcomes of 61 patients in whom IgA nephropathy was diagnosed before the age of 15 years from 1991 to 2005 and followed-up at least for one year. All patients were confirmed by renal biopsy. RESULTS: After mean follow-up of 5.2 years from onset, 24 patients of 61 (39.3%) were in clinical remission at the last examination. Thirty patients (49.2%) had hematuria or mild proteinuria (<1 g/ m2/d), five (8.2%) had severe proteinuria (> or =1 g/m2/d), and two (3.3%) had chronic renal failure. By univariate analysis, initial presentation at onset and Haas classification were less concordant with outcome. Hypertension during follow-up, rather than hypertension at presentation, was significantly correlated with outcomes (P<0.01). Sixty percent of patients who had more than 20% of glomerular sclerosis or crescent progressed to severe proteinuria or chronic renal failure, as compared with 7.1% of those who did not (P<0.01). CONCLUSION: Prognosis of childhood IgA nephropathy had a relatively benign course during a mean follow-up of 5.2 years. Persistent hypertension during follow-up and more than 20% of glomerular sclerosis or crescent were strong predictors of a progressive course of IgA nephropathy. A new histologic classification according to characteristics of childhood IgA nephropathy must be established to assess prognosis. Further efforts should be made to understand the prognosis of IgA nephropathy through long-term follow-up.
