title: Long-term morbidity of IgA nephropathy in children evaluated with newly proposed remission criteria in Japan.
abstract: BACKGROUND
  The long-term outcome of pediatric IgA nephropathy (IgAN) is unclear. Objective IgAN remission criteria were proposed by the Japanese Society of Nephrology in 2013.
  
  
  METHODS
  Children with newly developed IgAN followed for >5 years were analyzed. They were divided into two groups based on histological findings at initial kidney biopsy: the focal mesangial proliferation group (Focal group) and diffuse mesangial proliferation group (Diffuse group). The primary outcome was the remission rate according to the newly proposed IgAN remission criteria.
  
  
  RESULTS
  The patients comprised 53 children (31 boys; mean age at IgAN onset, 10.0 years). The Focal and Diffuse groups comprised 21 and 32 patients, respectively. No significant differences in patient characteristics were found between the groups except for steroid administration. The median follow-up period from onset was 9.9 years. Sixteen patients in the Diffuse group and 10 in the Focal group had not achieved remission at the last observation. Patient conditions 2 years after the initial treatment were almost identical to those at the last observation. Multivariate analysis revealed that proteinuria, particularly <0.5 g/g Cr at 2 years, was significantly associated with remission at the last observation regardless of proteinuria status at the start of treatment.
  
  
  CONCLUSIONS
  Pediatric IgAN has a prolonged course that is longer than expected regardless of severity at diagnosis. Patient conditions 2 years after initial treatment predicted their conditions at the last observation. Although the final renal function of these patients is presently unclear, children with IgAN should be followed beyond adolescence and further into adulthood.
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.|Division of Allergy, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
authors: Shoko
authors: S
authors: Matsushita
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan. kenzo@ii.e-mansion.com.
authors: Kenji
authors: K
authors: Ishikura
authors: Department of Pediatrics, Tokai University Hachioji Hospital, 1838 Ishikawa-cho, Hachioji, Tokyo, 192-0032, Japan.
authors: Shojiro
authors: S
authors: Okamoto
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.|Department of Pediatrics, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan.
authors: Yusuke
authors: Y
authors: Okuda
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.|Department of Pediatrics, National Hospital Organization, Hokkaido Medical Center, 5-7-1-1 Yamanote, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan.
authors: Yoshinobu
authors: Y
authors: Nagaoka
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
authors: Ryoko
authors: R
authors: Harada
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
authors: Riku
authors: R
authors: Hamada
authors: Department of Pediatrics, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Shiga, 520-2192, Japan.
authors: Tomoyuki
authors: T
authors: Sakai
authors: Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors: Yuko
authors: Y
authors: Hamasaki
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
authors: Hiroshi
authors: H
authors: Hataya
authors: Japan Clinical Research Support Unit, 1-10-5 Yushima, Bunkyo-ku, Tokyo, 113-0034, Japan.
authors: Takashi
authors: T
authors: Ando
authors: Division of Pathology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa, Tokyo, 190-8531, Japan.
authors: Kentaro
authors: K
authors: Ogata
authors: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo, 183-8561, Japan.
authors: Masataka
authors: M
authors: Honda
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001706:Biopsy; D002648:Child; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000473:pathology; D008297:Male; D050527:Mesangial Cells / Q000473:pathology; D011507:Proteinuria / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: Children; IgA nephropathy; Remission criteria