Course and long-term outcome of idiopathic IgA nephropathy in children.
The long-term outcome of idiopathic IgA nephropathy (IgAN) in children was investigated with regard to clinical course and biopsy changes. All patients with biopsy-verified IgAN (diagnosed by kidney biopsy 1970-1985) at three children's clinics in Sweden were included in the study. Thirty-four (10 females, 24 males), out of a total of 72 patients, had a follow-up period of 8 years or more (10.7 +/- 1.9 years, range 8-14). After this duration of follow-up, urine abnormalities were found in 47% (group A), proteinuria in 35%, hypertension in 9%, and decreased glomerular filtration rate (GFR) in 3% of patients. However, 53% had no clinical signs of disease (group B). GFR depression at the time of clinical presentation of IgAN was more common in group A than in group B (P = 0.017). At the first renal biopsy, which was performed after the same duration of IgAN in both groups, focal segmental glomerular changes were more often found in group A (P = 0.017), while diffuse proliferative changes were more common in group B (P = 0.031). The course of the IgAN was thus often very protracted, with some children developing hypertension as well as decreased renal function. However, after a period of 8 years or more of follow-up half of the patients did not show any clinical signs of the disease, which may indicate low disease activity or, possibly, recovery.
Linné
T
T
Department of Paediatrics, Karolinska Institute, St. Göran's Hospital, Stockholm, Sweden.
Berg
U
U
Bohman
S O
SO
Sigström
L
L
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000473:pathology*; D006417:Hematuria / Q000175:diagnosis; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis; D007668:Kidney / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D011507:Proteinuria / Q000175:diagnosis
D003404:Creatinine