Clinicopathological features and the prognosis of IgA nephropathy in Japanese children on long-term observation
| Autor: | Masato Isome, Hitoshi Suzuki, Junzo Suzuki, Yukihiko Kawasaki, Ruriko Nozawa, A Takahashi, Suzuki S |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Pathology Time Factors Adolescent Kidney Glomerulus Renal function urologic and male genital diseases Gastroenterology Nephropathy Japan Risk Factors Internal medicine medicine Humans Child Hematuria Retrospective Studies Proteinuria business.industry Incidence Incidence (epidemiology) Glomerulonephritis IGA Retrospective cohort study Glomerulonephritis General Medicine Prognosis medicine.disease Child Preschool Disease Progression Kidney Failure Chronic Female medicine.symptom business Follow-Up Studies Kidney disease |
| Zdroj: | Clinical Nephrology. 64:171-179 |
| ISSN: | 0301-0430 |
| Popis: | Aims Clinicopathological features were investigated to clarify the ultimate prognosis and prognostic indicators for patients with IgA nephropathy in Japanese children. Methods We evaluated the outcomes of 181 patients in whom IgA nephropathy was diagnosed before the age of 15 years since September 1979 and followed-up at least for three years with regard to clinical data at the onset of symptoms and renal histologic data. Results After mean follow-up of 7.3 years from onset, 91 patients of 181 (50.3%) were in clinical remission at the last examination, 24 (13.2%) had isolated hematuria, 59 (32.6%) had hematuria and proteinuria. Eighteen of 59 (9.9%) had proteinuria more than 1 g per 24 hours. Hypertension was observed in 12 cases and 7 (3.9%) developed end-stage renal disease. Except 7, no patient had reduced renal function and elevated serum creatinine at the final follow-up. Predicted renal survival rate from onset was 92.3% at 10 years and 89.1% at 20 years. In multivariable analysis, age at onset and chronic changes of tubulointerstitium were associated with poor outcome. Conclusions Of 181 children with IgA nephropathy, 50% regressed, remaining 46% had hematuria and/or proteinuria and 4% of patients lapsed into end-stage renal disease. Our results indicate that childhood IgA nephropathy has a benign course and the risk for end-stage renal disease is lower than that of adults. Age at onset and tubulointerstitial lesions were the strong predictors of a progressive course of childhood IgA nephropathy. |
| Databáze: | OpenAIRE |
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