title: IgA Nephropathy in Children: A Multicenter Study in Poland.
abstract: IgA nephropathy (IgAN) is the most common form of glomerulonephritis in pediatric population. The clinical presentation of the disease in children ranges from microscopic hematuria to end-stage kidney disease. The aim of the study was to retrospectively assess clinical and kidney biopsy features in children with IgAN. We assessed a cohort of 140 children, 88 boys, 52 girls with the diagnosis of IgAN in the period of 2000-2015, entered into the national Polish pediatric IgAN registry. The assessment included the following: proteinuria, hematuria, glomerular filtration rate (GFR), arterial blood pressure, and the renal pathological changes according to the Oxford classification and crescents formation, as modifiable and unmodifiable risk factors. The incidence of IgAN in Poland was set at 9.3 new cases per year. The mean age at onset of IgAN was 11.9 ± 4.3 years, and the most common presentation of the disease was the nephritic syndrome, recognized in 52 % of patients. Kidney biopsy was performed, on average, 1.3 ± 2.0 years after onset of disease. Based on the ROC analysis, a cut-off age at onset of disease for GFR <90 mL/min/1.73 m2(risk factor of progression) was calculated as 13.9 years. Unmodifiable lesions: segmental sclerosis, tubular atrophy/interstitial fibrosis (S1, T1-2) in the Oxford classification and crescents in kidney biopsy were significantly more common in Gr 1 (>13.9 years) compared with Gr 2 (<13.9 years), despite a significantly shorter time to kidney biopsy in the former. We conclude that IgAN in children may be an insidious disease. A regular urine analysis, especially after respiratory tract infections, seems the best way for an early detection of the disease.
authors: Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland. wasiaczki@wp.pl.
authors: M
authors: M
authors: Mizerska-Wasiak
authors: Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
authors: A
authors: A
authors: Turczyn
authors: Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
authors: A
authors: A
authors: Such
authors: Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
authors: K
authors: K
authors: Cichoń-Kawa
authors: Department of Pathology, Medical University of Warsaw, Warsaw, Poland.
authors: J
authors: J
authors: Małdyk
authors: Department of Pediatric Nephrology, Jagiellonian University, Cracow, Poland.
authors: M
authors: M
authors: Miklaszewska
authors: Department of Pediatric Nephrology, Jagiellonian University, Cracow, Poland.
authors: J
authors: J
authors: Pietrzyk
authors: Department of Pediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors: A
authors: A
authors: Rybi-Szumińska
authors: Department of Pediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.
authors: A
authors: A
authors: Wasilewska
authors: Department of Pediatrics and Nephrology, Ludwik Rydygier Hospital, Torun, Poland.
authors: A
authors: A
authors: Firszt-Adamczyk
authors: Department of Pediatrics and Nephrology, Ludwik Rydygier Hospital, Torun, Poland.
authors: R
authors: R
authors: Stankiewicz
authors: Department of Pediatrics, SMDZ in Zabrze, Silesian Medical University, Katowice, Poland.
authors: M
authors: M
authors: Szczepańska
authors: Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland.
authors: B
authors: B
authors: Bieniaś
authors: Department of Pediatric Nephrology, Medical University of Lublin, Lublin, Poland.
authors: M
authors: M
authors: Zajączkowska
authors: Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland.
authors: A
authors: A
authors: Pukajło-Marczyk
authors: Department of Pediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland.
authors: D
authors: D
authors: Zwolińska
authors: Department of Pediatrics, Immunology and Nephrology, Polish Mothers Memorial Hospital Research Institute, Lodz, Poland.
authors: K
authors: K
authors: Siniewicz-Luzeńczyk
authors: Department of Pediatrics, Immunology and Nephrology, Polish Mothers Memorial Hospital Research Institute, Lodz, Poland.
authors: M
authors: M
authors: Tkaczyk
authors: Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Warsaw, Poland.
authors: K
authors: K
authors: Gadomska-Prokop
authors: Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Warsaw, Poland.
authors: R
authors: R
authors: Grenda
authors: Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland.
authors: U
authors: U
authors: Demkow
authors: Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury Street, 02-091, Warsaw, Poland.
authors: M
authors: M
authors: Pańczyk-Tomaszewska
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001706:Biopsy; D001794:Blood Pressure; D002648:Child; D005260:Female; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D006417:Hematuria / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000473:pathology*; D008297:Male; D011044:Poland / Q000453:epidemiology; D011507:Proteinuria / Q000175:diagnosis; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Children; Glomerulonephritis; Hematuria; IgA nephropathy; IgA protein; Kidney; Proteinuria; ROC analysis; Respiratory infection