Your browser doesn't support javascript.
loading
Are children with IgA nephropathy different from adult patients?
Su, Baige; Jiang, Yuanyuan; Li, Zhihui; Zhou, Jianhua; Rong, Liping; Feng, Shipin; Zhong, Fazhan; Sun, Shuzhen; Zhang, Dongfeng; Xia, Zhengkun; Feng, Chunyue; Huang, Wenyan; Li, Xiaoyan; Chen, Chaoying; Hao, Zhihong; Wang, Mo; Qin, Li; Chen, Minguang; Li, Yuanyuan; Ding, Juanjuan; Bao, Ying; Liu, Xiaorong; Deng, Fang; Cheng, Xueqin; Zhang, Li; Zhang, Xuan; Yang, Huandan; Peng, Xiaojie; Sun, Qianliang; Deng, Linxia; Jiang, Xiaoyun; Xie, Min; Gao, Yan; Yu, Lichun; Liu, Ling; Gao, Chunlin; Mao, Jianhua; Zheng, Weihua; Dang, Xiqiang; Xia, Hua; Wang, Yujie; Zhong, Xuhui; Ding, Jie; Lv, Jicheng; Zhang, Hong.
Afiliación
  • Su B; Department of Pediatric Nephrology, Peking University First Hospital, No. 1 Xi An Men Da Jie, Beijing, 100034, People's Republic of China.
  • Jiang Y; Renal Division, Peking University First Hospital, No.8 Xi Shi Ku Da Jie, Beijing, 100034, People's Republic of China.
  • Li Z; Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
  • Zhou J; Department of Nephrology, Rheumatology and Immunology, Hunan Children's Hospital, Changsha, Hunan, China.
  • Rong L; Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430030, Hubei Province, China.
  • Feng S; Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
  • Zhong F; Department of Pediatric Nephrology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
  • Sun S; Pediatric Nephrology Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
  • Zhang D; Department of Pediatric Nephrology and Rheumatism and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China.
  • Xia Z; Nephrology and Immunology Department, Children's Hospital of Hebei Province, Shijiazhuang, Hebei Province, China.
  • Feng C; Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
  • Huang W; Department of Nephrology, Children Hospital of Zhejiang University School of Medicine, Hangzhou, China.
  • Li X; Department of Nephrology and Rheumatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  • Chen C; Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.
  • Hao Z; Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
  • Wang M; Department of Pediatric, Guangzhou First People's Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, China.
  • Qin L; Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China.
  • Chen M; Department of Pediatrics, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming Science and Technology University, Kunming, China.
  • Li Y; Department of Pediatric Nephrology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
  • Ding J; Department of Pediatrics, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, 350025, China.
  • Bao Y; Department of Nephrology, Rheumatology and Immunology, Fujian Children's Hospital, Fuzhou, 350014, China.
  • Liu X; Department of Pediatric Nephrology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, Hubei, China.
  • Deng F; Department of Nephrology, Xi'an Children's Hospital, Xian, Shaanxi, China.
  • Cheng X; Department of Pediatric Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
  • Zhang L; Department of Nephrology, Anhui Provincial Children's Hospital, Hefei, China.
  • Zhang X; Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, China.
  • Yang H; Department of Pediatric Nephrology, The First Hospital of Jilin University, Changchun, China.
  • Peng X; Department of General Medicine, Tianjin Children's Hospital, Tianjin, China.
  • Sun Q; Department of Nephrology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China.
  • Deng L; Department of Nephrology, Jiangxi Provincial Children's Hospital, Nanchang, 330006, China.
  • Jiang X; Department of Nephrology, Rheumatology and Immunology, Hunan Children's Hospital, Changsha, Hunan, China.
  • Xie M; Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430030, Hubei Province, China.
  • Gao Y; Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
  • Yu L; Department of Pediatric Nephrology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
  • Liu L; Pediatric Nephrology Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
  • Gao C; Department of Pediatric Nephrology and Rheumatism and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, China.
  • Mao J; Nephrology and Immunology Department, Children's Hospital of Hebei Province, Shijiazhuang, Hebei Province, China.
  • Zheng W; Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
  • Dang X; Department of Nephrology, Children Hospital of Zhejiang University School of Medicine, Hangzhou, China.
  • Xia H; Department of Nephrology and Rheumatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
  • Wang Y; Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.
  • Zhong X; Department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China.
  • Ding J; Medical Data Science Center, Medical Research Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
  • Lv J; Department of Pediatric Nephrology, Peking University First Hospital, No. 1 Xi An Men Da Jie, Beijing, 100034, People's Republic of China. xuhui7876@126.com.
  • Zhang H; Department of Pediatric Nephrology, Peking University First Hospital, No. 1 Xi An Men Da Jie, Beijing, 100034, People's Republic of China. djnc_5855@126.com.
Pediatr Nephrol ; 39(8): 2403-2412, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38578470
ABSTRACT

BACKGROUND:

Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN.

METHODS:

We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN.

RESULTS:

A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m2, p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids.

CONCLUSIONS:

Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children.
Asunto(s)
Palabras clave
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Proteinuria / Tasa de Filtración Glomerular / Glomerulonefritis por IGA Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Proteinuria / Tasa de Filtración Glomerular / Glomerulonefritis por IGA Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article