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Spontaneous remission in children with IgA nephropathy
Yuko Shima1, Koichi Nakanishi, Taketsugu Hama
1Department of Pediatrics, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan.
Pediatric Nephrology (Berlin, Germany)
|September 4, 2012
Summary
Many children with IgA nephropathy (IgAN) and minor glomerular abnormalities experience spontaneous remission without medication. Physicians should consider this possibility before aggressive treatment.
Area of Science:
- Pediatric Nephrology
- Immunology
- Glomerular Diseases
Background:
- IgA nephropathy (IgAN) can spontaneously remit in some patients, but data on childhood cases with specific histological features are limited.
- Minor glomerular abnormalities or focal mesangial proliferation (MGA/FMP) are common in childhood IgAN.
Purpose of the Study:
- To investigate the rate and characteristics of spontaneous remission in children diagnosed with IgAN and MGA/FMP.
- To assess the long-term outcomes, including recurrence, in pediatric IgAN patients achieving spontaneous remission.
Main Methods:
- Retrospective analysis of 96 children with newly diagnosed IgAN and MGA/FMP who did not receive medication.
- Kaplan-Meier method and Cox proportional hazard models were employed to analyze remission and recurrence rates.
Main Results:
- Over half (59.4%) of the pediatric patients achieved spontaneous remission.
- Cumulative spontaneous remission rates reached 57.5% at 5 years and 77.4% at 10 years post-onset.
- Recurrence of urinary abnormalities was observed in 17.5% of those who achieved remission, with 5-year recurrence-free rates at 79.9%.
Conclusions:
- Childhood IgAN with MGA/FMP demonstrates a higher-than-expected spontaneous remission rate.
- The findings suggest a conservative treatment approach for pediatric IgAN patients with MGA/FMP, acknowledging the potential for spontaneous recovery.
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