Long-term morbidity of IgA nephropathy in children evaluated with newly proposed remission criteria in Japan View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-03-24

AUTHORS

Shoko Matsushita, Kenji Ishikura, Shojiro Okamoto, Yusuke Okuda, Yoshinobu Nagaoka, Ryoko Harada, Riku Hamada, Tomoyuki Sakai, Yuko Hamasaki, Hiroshi Hataya, Takashi Ando, Kentaro Ogata, Masataka Honda

ABSTRACT

BackgroundThe long-term outcome of pediatric IgA nephropathy (IgAN) is unclear. Objective IgAN remission criteria were proposed by the Japanese Society of Nephrology in 2013.MethodsChildren with newly developed IgAN followed for >5 years were analyzed. They were divided into two groups based on histological findings at initial kidney biopsy: the focal mesangial proliferation group (Focal group) and diffuse mesangial proliferation group (Diffuse group). The primary outcome was the remission rate according to the newly proposed IgAN remission criteria.ResultsThe patients comprised 53 children (31 boys; mean age at IgAN onset, 10.0 years). The Focal and Diffuse groups comprised 21 and 32 patients, respectively. No significant differences in patient characteristics were found between the groups except for steroid administration. The median follow-up period from onset was 9.9 years. Sixteen patients in the Diffuse group and 10 in the Focal group had not achieved remission at the last observation. Patient conditions 2 years after the initial treatment were almost identical to those at the last observation. Multivariate analysis revealed that proteinuria, particularly <0.5 g/g Cr at 2 years, was significantly associated with remission at the last observation regardless of proteinuria status at the start of treatment.ConclusionsPediatric IgAN has a prolonged course that is longer than expected regardless of severity at diagnosis. Patient conditions 2 years after initial treatment predicted their conditions at the last observation. Although the final renal function of these patients is presently unclear, children with IgAN should be followed beyond adolescence and further into adulthood. More... »

PAGES

1149-1156

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10157-015-1105-3

DOI

http://dx.doi.org/10.1007/s10157-015-1105-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1014818682

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25800961


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32 schema:description BackgroundThe long-term outcome of pediatric IgA nephropathy (IgAN) is unclear. Objective IgAN remission criteria were proposed by the Japanese Society of Nephrology in 2013.MethodsChildren with newly developed IgAN followed for >5 years were analyzed. They were divided into two groups based on histological findings at initial kidney biopsy: the focal mesangial proliferation group (Focal group) and diffuse mesangial proliferation group (Diffuse group). The primary outcome was the remission rate according to the newly proposed IgAN remission criteria.ResultsThe patients comprised 53 children (31 boys; mean age at IgAN onset, 10.0 years). The Focal and Diffuse groups comprised 21 and 32 patients, respectively. No significant differences in patient characteristics were found between the groups except for steroid administration. The median follow-up period from onset was 9.9 years. Sixteen patients in the Diffuse group and 10 in the Focal group had not achieved remission at the last observation. Patient conditions 2 years after the initial treatment were almost identical to those at the last observation. Multivariate analysis revealed that proteinuria, particularly <0.5 g/g Cr at 2 years, was significantly associated with remission at the last observation regardless of proteinuria status at the start of treatment.ConclusionsPediatric IgAN has a prolonged course that is longer than expected regardless of severity at diagnosis. Patient conditions 2 years after initial treatment predicted their conditions at the last observation. Although the final renal function of these patients is presently unclear, children with IgAN should be followed beyond adolescence and further into adulthood.
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39 IgA nephropathy
40 IgAN
41 Japan
42 Japanese Society
43 administration
44 adolescence
45 adulthood
46 analysis
47 biopsy
48 characteristics
49 children
50 conditions
51 course
52 criteria
53 diagnosis
54 differences
55 diffuse group
56 final renal function
57 findings
58 focal
59 focal group
60 follow
61 function
62 group
63 histological findings
64 initial kidney biopsy
65 initial treatment
66 kidney biopsy
67 last observation
68 long-term morbidity
69 long-term outcomes
70 median follow
71 morbidity
72 multivariate analysis
73 nephrology
74 nephropathy
75 observations
76 onset
77 outcomes
78 patient characteristics
79 patient's condition
80 patients
81 pediatric IgA nephropathy
82 period
83 primary outcome
84 proliferation group
85 proteinuria
86 proteinuria status
87 rate
88 remission
89 remission criteria
90 remission rate
91 renal function
92 severity
93 significant differences
94 society
95 start
96 start of treatment
97 status
98 steroid administration
99 treatment
100 years
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