Asumi Higa1, Yuko Shima1, Taketsugu Hama1, Masashi Sato1, Hironobu Mukaiyama1, Hiroko Togawa1, Ryojiro Tanaka2, Kandai Nozu3, Mayumi Sako4, Kazumoto Iijima3, Koichi Nakanishi5, Norishige Yoshikawa1. 1. Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan. 2. Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan. 3. Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan. 4. Division for Clinical Trials, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan. 5. Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan. knakanis@wakayama-med.ac.jp.
Abstract
BACKGROUND: Some patients with childhood immunoglobulin A nephropathy (IgAN) progress to end-stage renal disease within 20 years, while others achieve spontaneous remission even without medication. Prognosis of IgAN with minimal proteinuria (MP-IgAN, <0.5 g/day/1.73 m(2)) at diagnosis seems to be generally good. However, the long-term outcome for patients with childhood MP-IgAN has not yet been determined. METHODS: We retrospectively analyzed 385 children newly diagnosed with biopsy-proven IgAN between June 1976 and July 2009 whose renal biopsy specimens could be evaluated by the Oxford classification criteria. Of these 385 children with IgAN, 106 (27.5%) were diagnosed with MP-IgAN. We compared clinical and pathological findings between the 106 patients with MP-IgAN and the remaining 279 patients to elucidate the characteristics of MP-IgAN in children. RESULTS: Patients with MP-IgAN were identified through a school screening program (73.6%) or upon presentation with gross hematuria (26.4%). Patients with MP-IgAN had significantly milder pathological symptoms than those with IgAN. The most frequently used therapeutic regimes were angiotensin converting enzyme inhibitors (30.2%) and no therapy (36.8%). None of the patients with MP-IgAN reached stage III chronic kidney disease within 15 years after onset. Four patients with MP-IgAN (3.8 %) received immunosuppressive therapy during the course of the disease. CONCLUSION: Our results indicate that the outcome of patients with a diagnosis of childhood MP-IgAN is good, but that careful long-term observation is required.
BACKGROUND: Some patients with childhood immunoglobulin A nephropathy (IgAN) progress to end-stage renal disease within 20 years, while others achieve spontaneous remission even without medication. Prognosis of IgAN with minimal proteinuria (MP-IgAN, <0.5 g/day/1.73 m(2)) at diagnosis seems to be generally good. However, the long-term outcome for patients with childhood MP-IgAN has not yet been determined. METHODS: We retrospectively analyzed 385 children newly diagnosed with biopsy-proven IgAN between June 1976 and July 2009 whose renal biopsy specimens could be evaluated by the Oxford classification criteria. Of these 385 children with IgAN, 106 (27.5%) were diagnosed with MP-IgAN. We compared clinical and pathological findings between the 106 patients with MP-IgAN and the remaining 279 patients to elucidate the characteristics of MP-IgAN in children. RESULTS:Patients with MP-IgAN were identified through a school screening program (73.6%) or upon presentation with gross hematuria (26.4%). Patients with MP-IgAN had significantly milder pathological symptoms than those with IgAN. The most frequently used therapeutic regimes were angiotensin converting enzyme inhibitors (30.2%) and no therapy (36.8%). None of the patients with MP-IgAN reached stage III chronic kidney disease within 15 years after onset. Four patients with MP-IgAN (3.8 %) received immunosuppressive therapy during the course of the disease. CONCLUSION: Our results indicate that the outcome of patients with a diagnosis of childhood MP-IgAN is good, but that careful long-term observation is required.
Authors: Ian S D Roberts; H Terence Cook; Stéphan Troyanov; Charles E Alpers; Alessandro Amore; Jonathan Barratt; Francois Berthoux; Stephen Bonsib; Jan A Bruijn; Daniel C Cattran; Rosanna Coppo; Vivette D'Agati; Giuseppe D'Amico; Steven Emancipator; Francesco Emma; John Feehally; Franco Ferrario; Fernando C Fervenza; Sandrine Florquin; Agnes Fogo; Colin C Geddes; Hermann-Josef Groene; Mark Haas; Andrew M Herzenberg; Prue A Hill; Ronald J Hogg; Stephen I Hsu; J Charles Jennette; Kensuke Joh; Bruce A Julian; Tetsuya Kawamura; Fernand M Lai; Lei-Shi Li; Philip K T Li; Zhi-Hong Liu; Bruce Mackinnon; Sergio Mezzano; F Paolo Schena; Yasuhiko Tomino; Patrick D Walker; Haiyan Wang; Jan J Weening; Nori Yoshikawa; Hong Zhang Journal: Kidney Int Date: 2009-07-01 Impact factor: 10.612
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Authors: Rosanna Coppo; Danilo Lofaro; Roberta R Camilla; Shubha Bellur; Daniel Cattran; H Terence Cook; Ian S D Roberts; Licia Peruzzi; Alessandro Amore; Francesco Emma; Laura Fuiano; Ulla Berg; Rezan Topaloglu; Yelda Bilginer; Loreto Gesualdo; Rosaria Polci; Malgorzata Mizerska-Wasiak; Yasar Caliskan; Sigrid Lundberg; Giovanni Cancarini; Colin Geddes; Jack Wetzels; Andrzej Wiecek; Magdalena Durlik; Stefano Cusinato; Cristiana Rollino; Milena Maggio; Manuel Praga; Hilde K Smerud; Vladimir Tesar; Dita Maixnerova; Jonathan Barratt; Teresa Papalia; Renzo Bonofiglio; Gianna Mazzucco; Costantinos Giannakakis; Magnus Soderberg; Diclehan Orhan; Anna Maria Di Palma; Jadwiga Maldyk; Yasemin Ozluk; Birgitta Sudelin; Regina Tardanico; David Kipgen; Eric Steenbergen; Henryk Karkoszka; Agnieszka Perkowska-Ptasinska; Franco Ferrario; Eduardo Gutierrez; Eva Honsova Journal: Pediatr Nephrol Date: 2016-08-25 Impact factor: 3.714