Clinical significance of apolipoprotein (a) deposition in kidney diseases of children.
OBJECTIVE
To address the clinical significance of lipoprotein (a) (Lp(a)) deposition in renal diseases of children, we examined renal localization of apolipoprotein (a) (apo(a)), which is the major apoprotein of Lp(a), using a new monoclonal antibody as a probe, and compared histological changes and clinical courses between the cases with and without apo(a) accumulation. Our study comprised 78 cases with various renal diseases.


RESULTS
Of the 78 cases, 45 showed apo(a) deposition (group A) and the other 33 did not (group B). Nephrotic syndrome was similarly presented in groups A and B (46.7% vs 36.3%). Histological findings were analyzed in 62 proliferative and 16 non-proliferative original diseases separately. In the cases with proliferative diseases, severe histological changes were observed in group A more than in group B, severe proliferation (50.9% vs 26.1%: p < 0.01) and crescent formation (11.9% vs 5.1%: p < 0.01) were observed in group A over that of group B. However, the clinical status at the latest follow-up were quite similar, there was no difference of favorable (60.5% vs 62.5%) and unfavorable outcome (15.9% vs 16.7%) in groups A and B. In the cases with non-proliferative diseases, global sclerosis was more often encountered in group A than in group B (28.3% vs 6.5%). Group A carried poorer prognosis than group B in non-proliferative diseases.


CONCLUSIONS
These results suggest that apo(a) deposits just passively follow the histological injury, and they do not always accelerate it.
Nakahara
C
C
Department of Pediatrics, University of Tsukuba, Japan.
Nagata
M
M
Watanabe
T
T
Kobayashi
K
K
Hamaguchi
H
H
Kanemoto
K
K
Kashiwagi
R
R
Matsui
A
A
D000293:Adolescent; D001054:Apolipoproteins A / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000378:metabolism* / Q000473:pathology; D007678:Kidney Glomerulus / Q000378:metabolism* / Q000473:pathology; D017270:Lipoprotein(a) / Q000378:metabolism*; D008297:Male
D001054:Apolipoproteins A; D017270:Lipoprotein(a)