title: Spontaneous remission in children with IgA nephropathy.
abstract: BACKGROUND
  Some patients with IgA nephropathy (IgAN) achieve spontaneous remission even when not receiving medication. However, details on such remissions remain unknown. The aim of our study was to clarify this information in the clinical setting of childhood IgAN with minor glomerular abnormalities or focal mesangial proliferation (MGA/FMP).
  
  
  METHODS
  This study was a retrospective analysis of 96 children with MGA/FMP who did not receive medication from among the 555 patients with newly diagnosed childhood IgAN treated between January 1972 and December 2000. The Kaplan-Meier method and Cox proportional hazard model were used for the analysis.
  
  
  RESULTS
  Of the 96 pediatric patients who did not receive medication, 57 (59.4 %) achieved spontaneous remission. The cumulative spontaneous remission rates among these patients were 57.5 and 77.4 % at 5 and 10 years, respectively, from onset. The mean time from onset to remission was 5.9 ± 0.4 years. Clinical and histological findings were similar between the remission and non-remission groups. Of the 57 patients with spontaneous remissions, ten (17.5 %) also developed a recurrence of urinary abnormalities. The cumulative recurrence-free rates were 79.9 and 67.9 % at 5 and 10 years, respectively, after remission.
  
  
  CONCLUSIONS
  The spontaneous remission rate in childhood IgAN with MGA/FMP was higher than expected. Our results suggest that physicians should consider the potential for spontaneous remission and refrain from very aggressive treatment in IgAN patients with MGA/FMP.
authors.affiliation: Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Shima
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Taketsugu
authors.initials: T
authors.lastname: Hama
authors.forename: Hironobu
authors.initials: H
authors.lastname: Mukaiyama
authors.forename: Hiroko
authors.initials: H
authors.lastname: Togawa
authors.forename: Mayumi
authors.initials: M
authors.lastname: Sako
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaito
authors.forename: Kandai
authors.initials: K
authors.lastname: Nozu
authors.forename: Ryojiro
authors.initials: R
authors.lastname: Tanaka
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
mesh_terms: D002648:Child; D005260:Female; D005922:Glomerulonephritis, IGA; D006801:Humans; D008297:Male; D012075:Remission, Spontaneous