Clinicopathologic Changes of IgA Nephropathy in Children During Long-term (average 10.8 yrs) Follow-up
Journal of the Korean Society of Pediatric Nephrology
; : 154-165, 2010.
Article
Dans Ko
| WPRIM
| ID: wpr-27461
Responsable en Bibliothèque :
WPRO
ABSTRACT
PURPOSE:
We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN.METHODS:
From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features.RESULTS:
Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P=0.01) and last Haas classification (P=0.007). None of the cases showed progression to CRF or ESRD.CONCLUSION:
During a mean follow-up of 10.8+/-3.4 years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Pronostic
/
Biopsie
/
Immunoglobuline A
/
Inhibiteurs de l'enzyme de conversion de l'angiotensine
/
Dossiers médicaux
/
Études de suivi
/
Ciclosporine
/
Antagonistes des récepteurs aux angiotensines
/
Glomérulonéphrite à dépôts d'IgA
/
Hypertension artérielle
Type d'étude:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites du sujet:
Child
/
Humans
langue:
Ko
Texte intégral:
Journal of the Korean Society of Pediatric Nephrology
Année:
2010
Type:
Article