[Long-term prognosis of childhood IgA nephropathy in adult life].
BACKGROUND
To evaluate long-term prognosis in a group of children with IgA nephropathy and to analyse which clinical factors were associated with progression to chronic renal failure in adulthood.


METHODS
Retrospective study. 58 young adults with IgA nephropathy diagnosed at 10.6(SD 2.9) years old and studied after a follow-up of 11.8 (SD 2.9) years.


RESULTS
Relapses of macroscopic hematuria and proteinuria were the most frequent symptoms at onset (75.9%). In 25.9% of patients high plasmatic IgA levels were also detected. Most cases had grade I (44.8%)or grade II (44.8%) histological lesions at diagnosis. At the last control, clinical remision was observed in 21 patients (36.2%) and 50% of the whole group remained with abnormal urine. 8 patients(13.8%) reached terminal renal failure. Mean renal survival (defined as glomerular filtration rate above 50 ml/min/1.73 m2)was 100, 93.3 and 81.1% at 5, 10 and 15 years of evolution, respectively.


CONCLUSIONS
About 14% of children with IgA nephropathy had long-term renal bad prognosis. Hypertension at onset, plasma creatinine elevation and proteinuria during adolescence were significant risk factors associated with chronic renal failure during adulthood. Minimal lesions at IgA nephropathy diagnosis in children did not exclude long-term poor prognosis.
Ariceta
G
G
Sección de Nefrología Pediátrica, Departamento de Pediatría, Hospital de Cruces, Vizcaya, Madrid.
Gallego
N
N
López-Fernández
Y
Y
Vallo
A
A
Quintela
M J
MJ
Rodríguez Soriano
J
J
D000328:Adult; D002648:Child; D005260:Female; D005922:Glomerulonephritis, IGA / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis