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[Analysis of 94 cases of IgA nephropathy in children]
Hua-Xiong Mao1, Zhu-Wen Yi, Li Liang
1Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Insights
The incidence of IgA nephropathy (IgAN) in children is rising alongside hospitalizations and kidney biopsies. Hematuria is the primary symptom, with inflammation and fibrosis common pathological features.
Area of Science:
- Pediatric Nephrology
- Immunology
- Pathology
Context:
- IgA nephropathy (IgAN) is a significant cause of childhood kidney disease.
- Understanding its clinical and pathological spectrum in pediatric populations is crucial for effective management.
- This study examines IgAN cases in Hunan province, China, over a decade.
Purpose:
- To evaluate the clinical and pathological characteristics of 94 children diagnosed with IgA nephropathy.
- To estimate the prevalence and trends of IgAN among hospitalized children in Hunan province between 1995 and 2004.
Summary:
- A 10-year review identified 94 pediatric IgA nephropathy cases, with increasing incidence correlating with overall hospitalizations and kidney biopsies.
- Hematuria was the predominant clinical sign (76%), particularly in non-nephrotic/non-proteinuric cases (98%).
- Key pathological findings included inflammation (91%), tubular degeneration (81%), and interstitial fibrosis (31%), especially in nephrotic syndrome IgAN.
Impact:
- Highlights the rising trend of IgA nephropathy in children, emphasizing the importance of early diagnosis through urine analysis and biopsy.
- Identifies key pathological features, suggesting proteinuria control may mitigate renal tubule fibrosis.
- Provides epidemiological data on IgAN in a specific Chinese province, aiding regional health planning.
Objective:
To evaluate the clinical and pathological features of 94 children suffering from IgA nephropathy (IgAN) while estimating the prevalent situation in Hunan province.
Methods:
To summarize the annual number of hospitalized children, those with kidney diseases, those accepted biopsy, and those confirmed as IgAN in both Xiangya Hospital and Second Xiangya Hospital undertaking kidney biopsy in Hunan province during 1995 and 2004.
Results:
In the past 10 years, as the hospitalized population in both hospitals accrued to 9.98% each year. The rate of 7.5% was seen in those with kidney diseases. Among whom 56.3% accepted kidney biopsy and 94 of them were confirmed as IgAN. Hematuria was the main clinical presentation, seen in 71 cases, accounting to 76%, and even to 98% after excluding those with nephrotic syndrome and isolating proteinuria type of IgAN. Inflammation infiltration (91%), renal tubule degeneration (81%), and renal interstitial fibrosis (31%) were the major pathological features of 94 children, especially in nephrotic syndrome IgAN.
Conclusion:
The number of children with IgAN synchronously accrues as hospitalized population, those with kidney diseases, and those by kidney biopsy. Hematuria is the major symptom. To routinely perform urine analysis and kidney biopsy in asymptomatic hematuria may improve the diagnosis. Inflammation infiltration, renal tubule degeneration, and renal interstitial fibrosis are the major pathological features in IgAN children, especially in nephrotic syndrome IgAN, probably relating to continuous proteinuria. Early control of proteinuria may delay or decrease renal tubule fibrosis.
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