Remission of proteinuria may protect against progression to chronic kidney disease in pediatric-onset IGA nephropathy

Jin Soon Suh, Kyung Mi Jang, Hyesun Hyun, Myung Hyun Cho, Joo Hoon Lee, Young Seo Park, Jae Hyuk Oh, Ji Hong Kim, Kee Hwan Yoo, Woo Yeong Chung, Seong Heon Kim, Keehyuck Kim, Dae Yeol Lee, Jung Won Lee, Min Hyun Cho, Hyewon Park, Ja Wook Koo, Kyoung Hee Han, Eun Mi Yang, Keum Hwa LeeJae Il Shin, Heeyeon Cho, Kyo Soon Kim, Il Soo Ha, Yong Hoon Park, Hee Gyung Kang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulopathies diagnosed in children and adolescents. This study aimed to evaluate the clinical features in and outcomes of pediatric IgAN over the last 30 years. Patients who were diagnosed before age of 18 at 20 centers in Korea were evaluated retrospectively. Of the 1154 patients (768 males, 386 females) with a median follow-up of 5 years, 5.6% (n = 65) progressed to stage 3–5 chronic kidney disease (CKD). The 10-and 20-year CKD-free survival rates were 91.2% and 75.6%, respectively. Outcomes did not differ when comparing those in Korea who were diagnosed prior to versus after the year 2000. On multivariate analysis, combined asymptomatic hematuria and proteinuria as presenting symptoms and decreased renal function at the time of biopsy were associated with progression to CKD, while remission of proteinuria was negatively associated with this outcome. Patients who presented with gross hematuria or nephrotic syndrome tended toward positive outcomes, especially if they ultimately achieved remission. While remission of proteinuria might imply that the disease is inherently less aggressive, it also can be achieved by management. Therefore, more aggressive management might be required for pediatric-onset IgAN.

Original languageEnglish
Article number2058
Pages (from-to)1-17
Number of pages17
JournalJournal of Clinical Medicine
Volume9
Issue number7
DOIs
StatePublished - Jul 2020

Keywords

  • Children
  • IgA nephropathy
  • Long-term outcome
  • Remission of proteinuria

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