title: The Oxford IgA nephropathy clinicopathological classification is valid for children as well as adults.
abstract: To study the predictive value of biopsy lesions in IgA nephropathy in a range of patient ages we retrospectively analyzed the cohort that was used to derive a new classification system for IgA nephropathy. A total of 206 adults and 59 children with proteinuria over 0.5 g/24 h/1.73 m(2) and an eGFR of stage-3 or better were followed for a median of 69 months. At the time of biopsy, compared with adults children had a more frequent history of macroscopic hematuria, lower adjusted blood pressure, and higher eGFR but similar proteinuria. Although their outcome was similar to that of adults, children had received more immunosuppressants and achieved a lower follow-up proteinuria. Renal biopsies were scored for variables identified by an iterative process as reproducible and independent of other lesions. Compared with adults, children had significantly more mesangial and endocapillary hypercellularity, and less segmental glomerulosclerosis and tubulointerstitial damage, the four variables previously identified to predict outcome independent of clinical assessment. Despite these differences, our study found that the cross-sectional correlation between pathology and proteinuria was similar in adults and children. The predictive value of each specific lesion on the rate of decline of renal function or renal survival in IgA nephropathy was not different between children and adults.
authors.affiliation: Regina Margherita Children's Hospital, Turin, Italy. rosanna.coppo@unito.it
authors.forename: Rosanna
authors.initials: R
authors.lastname: Coppo
authors.forename: Stéphan
authors.initials: S
authors.lastname: Troyanov
authors.forename: Roberta
authors.initials: R
authors.lastname: Camilla
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Hogg
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cattran
authors.forename: H Terence
authors.initials: HT
authors.lastname: Cook
authors.forename: John
authors.initials: J
authors.lastname: Feehally
authors.forename: Ian S D
authors.initials: IS
authors.lastname: Roberts
authors.forename: Alessandro
authors.initials: A
authors.lastname: Amore
authors.forename: Charles E
authors.initials: CE
authors.lastname: Alpers
authors.forename: Jonathan
authors.initials: J
authors.lastname: Barratt
authors.forename: Francois
authors.initials: F
authors.lastname: Berthoux
authors.forename: Stephen
authors.initials: S
authors.lastname: Bonsib
authors.forename: Jan A
authors.initials: JA
authors.lastname: Bruijn
authors.forename: Vivette
authors.initials: V
authors.lastname: D'Agati
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Amico
authors.forename: Steven N
authors.initials: SN
authors.lastname: Emancipator
authors.forename: Francesco
authors.initials: F
authors.lastname: Emma
authors.forename: Franco
authors.initials: F
authors.lastname: Ferrario
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Fervenza
authors.forename: Sandrine
authors.initials: S
authors.lastname: Florquin
authors.forename: Agnes B
authors.initials: AB
authors.lastname: Fogo
authors.forename: Colin C
authors.initials: CC
authors.lastname: Geddes
authors.forename: Hermann J
authors.initials: HJ
authors.lastname: Groene
authors.forename: Mark
authors.initials: M
authors.lastname: Haas
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Herzenberg
authors.forename: Prue A
authors.initials: PA
authors.lastname: Hill
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Hsu
authors.forename: J Charles
authors.initials: JC
authors.lastname: Jennette
authors.forename: Kensuke
authors.initials: K
authors.lastname: Joh
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Julian
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawamura
authors.forename: Fernand M
authors.initials: FM
authors.lastname: Lai
authors.forename: Lei S
authors.initials: LS
authors.lastname: Li
authors.forename: Philip K
authors.initials: PK
authors.lastname: Li
authors.forename: Zhi H
authors.initials: ZH
authors.lastname: Liu
authors.forename: Sergio
authors.initials: S
authors.lastname: Mezzano
authors.forename: F Paolo
authors.initials: FP
authors.lastname: Schena
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomino
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Walker
authors.forename: Haiyan
authors.initials: H
authors.lastname: Wang
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Weening
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001706:Biopsy; D002648:Child; D002908:Chronic Disease; D005260:Female; D005921:Glomerulonephritis / Q000145:classification / Q000473:pathology; D005922:Glomerulonephritis, IGA / Q000145:classification* / Q000473:pathology*; D006417:Hematuria / Q000145:classification / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000145:classification; D007668:Kidney / Q000473:pathology; D007677:Kidney Function Tests; D008297:Male; D011507:Proteinuria / Q000145:classification / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents