IgA nephropathy in children: before and after the start of COVID-19.

Autor: Leow EH; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore. Esther.Leow.H.M@singhealth.com.sg., Chong SL; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore., Yap CJY; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore., Chao SM; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore., Ganesan I; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore., Wang F; Nursing Clinical Services, KK Women's and Children's Hospital, Singapore, Singapore., Ng YH; Paediatric Medicine, Nephrology Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Apr; Vol. 39 (4), pp. 1161-1167. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1007/s00467-023-06196-2
Abstrakt: Background: We describe the clinical course of children with IgA nephropathy (IgAN), diagnosed before and after the emergence of COVID-19. We hypothesized that COVID-19 vaccination and/or infection resulted in more children with IgAN to present clinically.
Methods: We conducted a retrospective cohort study of children with IgAN diagnosed on kidney biopsy from 2014-2020 (Period 1) and 2021-2022 (Period 2). Baseline characteristics, clinical presentation, investigations and treatments were compared between patients diagnosed in Period 1 and Period 2, as well as between patients with and without chronic changes on kidney biopsy. Continuous variables were compared using the Wilcoxon rank sum test. Categorical variables were compared using χ2 or Fisher exact tests.
Results: Nineteen children with IgAN were diagnosed by kidney biopsy, with 10 during Period 1 and 9 patients during Period 2 (an average of 1-2 patients/year and 4-5 patients/year in Periods 1 and 2, respectively). The most common indication for kidney biopsy is proteinuria with urine protein/creatinine ratio 1.4 (interquartile range [IQR] 1.2-9.0) vs. 0.8 (IQR 0.6-1.5) g/g (p = 0.064) at time of kidney biopsy for patients in Period 1 and 2, respectively. Clinical course was similar in both periods. No patient required acute or chronic kidney replacement therapy.
Conclusions: The rate of diagnosing children with IgAN was higher since the emergence of COVID-19, suggesting that COVID-19 may trigger an immune response responsible for IgAN, similar to other mucosal infections.
(© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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