| Clinicopathologic features and prognosis of childhood IgA nephropathy |
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Sung Il Woo1, Keun Wook Bae1, Joo Hoon Lee1, Young Seo Park1, Yong Mee Cho2 |
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
| 소아 IgA 신병증의 임상병리학적 양상과 예후 |
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우성일1, 배근욱1, 이주훈1, 박영서1, 조영미2 |
1울산대학교 의과대학 서울아산병원 소아과
2울산대학교 의과대학 서울아산병원 병리과 |
Correspondence:
Young Seo Park, Email: yspark@amc.seoul.kr
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| 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 ( 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. |
| Key Words:
Glomerulonephritis , IGA , Children , Prognosis |
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