Korean J Pediatr.  2007 Feb;50(2):170-177. 10.3345/kjp.2007.50.2.170.

Clinicopathologic features and prognosis of childhood IgA nephropathy

• Woo SI
• Bae KW
• Lee JH
• Park YS
• Cho YM

• KMID: 2278721
• DOI: http://doi.org/10.3345/kjp.2007.50.2.170

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.

Keyword

Glomerulonephritis; IGA; Children; Prognosis

MeSH Terms

Biopsy
Child
Classification
Follow-Up Studies
Glomerulonephritis
Glomerulonephritis, IGA*
Hematuria
Humans
Hypertension
Immunoglobulin A*
Kidney Failure, Chronic
Prognosis*
Proteinuria
Sclerosis
Immunoglobulin A