The Oxford IgA nephropathy clinicopathological classification is valid for children as well as adults.
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.
Regina Margherita Children's Hospital, Turin, Italy. rosanna.coppo@unito.it
Coppo
Rosanna
R
Troyanov
Stéphan
S
Camilla
Roberta
R
Hogg
Ronald J
RJ
Cattran
Daniel C
DC
Cook
H Terence
HT
Feehally
John
J
Roberts
Ian S D
IS
Amore
Alessandro
A
Alpers
Charles E
CE
Barratt
Jonathan
J
Berthoux
Francois
F
Bonsib
Stephen
S
Bruijn
Jan A
JA
D'Agati
Vivette
V
D'Amico
Giuseppe
G
Emancipator
Steven N
SN
Emma
Francesco
F
Ferrario
Franco
F
Fervenza
Fernando C
FC
Florquin
Sandrine
S
Fogo
Agnes B
AB
Geddes
Colin C
CC
Groene
Hermann J
HJ
Haas
Mark
M
Herzenberg
Andrew M
AM
Hill
Prue A
PA
Hsu
Stephen I
SI
Jennette
J Charles
JC
Joh
Kensuke
K
Julian
Bruce A
BA
Kawamura
Tetsuya
T
Lai
Fernand M
FM
Li
Lei S
LS
Li
Philip K
PK
Liu
Zhi H
ZH
Mezzano
Sergio
S
Schena
F Paolo
FP
Tomino
Yasuhiko
Y
Walker
Patrick D
PD
Wang
Haiyan
H
Weening
Jan J
JJ
Yoshikawa
Norishige
N
Zhang
Hong
H
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
D007166:Immunosuppressive Agents