IgM deposition is a risk factor for delayed remission and early relapse of the pediatric minimal change disease

Autor: Tao Ju, Yingchao Peng, Yaqin Wei, Xiaojie Li, Meiqiu Wang, Ren Wang, Xiao Yang, Zhiqiang Zhang, Chunlin Gao, Zhengkun Xia
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Pediatrics, Vol 11 (2023)
Druh dokumentu: article
ISSN: 2296-2360
DOI: 10.3389/fped.2023.1072969
Popis: BackgroundMinimal change disease (MCD) is the most common pathological subtype of pediatric idiopathic nephrotic syndrome (INS). It has been suggested that IgM deposition might predict kidney function deterioration in the course of MCD. However, the specific role of IgM deposition in the prognosis of MCD is still controversial. This study aims to investigate the clinical significance of IgM deposition on delayed remission and early relapse in a pediatric population.MethodsThis study enrolled 283 children diagnosed with MCD by renal biopsy in a single center from 2010 to 2022. These cases were divided into two groups according to the histopathological deposition of IgM. Patients' demographics, clinical parameters, and follow-up data were collected and analyzed. The primary and secondary outcomes were defined as the time to the first remission and the first relapse.ResultsThe IgM-positive group had a weaker response to steroids (steroid-sensitive: 23.5% vs. 40.8%; steroid-dependent: 74.0% vs. 51.0%; steroid-resistant: 18.4% vs. 8.2%, P = 0.001), and showed more recurrent cases (47.2% vs. 34.4%, P = 0.047) compared with the IgM-negative group. The Kaplan-Meier analysis showed that the IgM-positive group had a lower cumulative rate of the first remission (Log-rank, P
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