Progress on prognosis factors for IgA nephropathy in children
10.3760/cma.j.issn.1673-4408.2025.03.005
- VernacularTitle:儿童IgA肾病预后影响因素的研究进展
- Author:
Ni TANG
1
;
Chunhua ZHU
;
Aihua ZHANG
Author Information
1. 南京医科大学附属儿童医院肾脏科 210008
- Keywords:
Children;
Glomerulonephritis;
IgA nephropathy;
Prognosis
- From:
International Journal of Pediatrics
2025;52(3):165-169
- CountryChina
- Language:Chinese
-
Abstract:
IgA nephropathy（IgAN）is a common primary glomerular disease in children，characterized by the deposition of IgA or IgA-dominant immune complexes in the glomeruli.The clinical manifestations are highly heterogeneous，with some children progressing to end-stage renal disease.The prognosis of IgAN is influenced by multiple factors，involving clinical，pathological，and laboratory examinations.Among the clinical factors，persistent proteinuria，reduced baseline estimated glomerular filtration rate（eGFR），hypertension during follow-up，and hyperuricemia are risk factors for poor prognosis.The predictive value of hematuria remains controversial.Pathologically，the Oxford classification highlights that segmental sclerosis，tubular atrophy/interstitial fibrosis，and crescents are significantly associated with disease progression，with tubular atrophy/interstitial fibrosis serving as an independent risk factor for poor outcomes.The prognostic significance of mesangial hypercellularity and endocapillary hypercellularity requires further validation.Among the biomarkers，serum galactose-deficient IgA 1 and complement-related markers（such as IgA/C3 ratio）show potential predictive value，but need to be supported by large samples studies.This article reviews the clinical，pathological，and biomarker-related risk factors influencing the prognosis of pediatric IgAN，aiming to provide basis for developing risk prediction models and guiding individualized treatment strategies.
