Related Experiment Video
Updated: Mar 14, 2026
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Predictors of Progression in IgA Nephropathy in Childhood
M Mizerska-Wasiak1, J Małdyk2, A Turczyn3
1Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Zwirki i Wigury St., Warsaw, 02-091, Poland. wasiaczki@wp.pl.
Insights
Predictors of poor prognosis in childhood IgA nephropathy include reduced glomerular filtration rate (GFR), nephrotic range proteinuria at onset, and high MEST scores. The IgA/C3 serum ratio is not a reliable predictor of disease progression.
Area of Science:
- Pediatric Nephrology
- Immunology
- Renal Pathology
Background:
- IgA nephropathy (IgAN) is a common cause of glomerulonephritis in children.
- Identifying predictors of poor prognosis is crucial for timely intervention and management.
- The Oxford classification and MEST score are established tools for assessing IgAN severity.
Purpose of the Study:
- To evaluate the predictive value of proteinuria, glomerular filtration rate (GFR), and serum IgA/C3 ratio for poor prognosis in pediatric IgAN.
- To assess the association between MEST score and clinical outcomes in children with IgAN.
Main Methods:
- Retrospective study of 55 children with IgAN, diagnosed using Oxford classification and MEST score.
- Assessment of proteinuria, GFR, and IgA/C3 ratio at disease onset and follow-up.
- Statistical analysis including ROC AUC curves and logistic regression to identify prognostic factors.
Main Results:
- Reduced GFR at onset was significantly associated with reduced GFR at follow-up (AUC=0.660, p<0.05).
- Nephrotic range proteinuria at onset predicted higher likelihood of proteinuria at follow-up (AUC=0.760, p<0.05).
- High MEST score (≥3) tended to associate with reduced GFR (AUC=0.650, p=0.07) but not proteinuria. The IgA/C3 ratio was higher at follow-up in children with impaired renal function, but not predictive at onset.
Conclusions:
- GFR reduction, nephrotic range proteinuria at onset, and high MEST scores are significant predictors of poor outcome in childhood IgAN.
- The serum IgA/C3 ratio at disease onset does not reliably predict long-term GFR reduction or persistent proteinuria.
- Further research may explore other biomarkers for predicting IgAN progression in children.
Abstract:
The aim of this retrospective study was to assess the usefulness of potential predictors of poor prognosis in IgA nephropathy in children. The study population consisted of 55 children aged 11 ± 4 years, diagnosed on the basis of the Oxford classification and MEST score of kidney biopsy findings. Proteinuria, glomerular filtration rate (GFR), and the IgA/C3 serum ratio were assessed in all patients twice: at onset and at follow-up. The patients were treated with steroids, immunosuppressive drugs, and/or angiotensin-converting enzyme inhibitors. Follow-up was at 3.9 ± 2.9 (median 2.7) years. The patients were subdivided into two groups: with GFR <90 and ≥90 mL/min at follow-up. ROC AUC curves and logistic regression were used to evaluate the power of prognostic factors. The two groups did not differ regarding the level of proteinuria, MEST score, and the IgA/C3 ratio at onset of disease. There was a significant association between GFR reductions at onset and follow-up (AUC = 0.660; p < 0.05). In patients with nephrotic range proteinuria at onset, proteinuria at follow-up was more frequent compared with other patients (AUC = 0.760; p < 0.05), MEST score ≥3 tended to be associated with reduced GFR (AUC = 0.650; p = 0.07) but not with proteinuria (AUC = 0.608; p = 0.47), and the IgA/C3 ratio was higher (p < 0.05) at follow-up. No significant associations were found between the IgA/C3 ratio at onset and reduced GFR (AUC = 0.565; p = 0.46) or proteinuria at follow-up (AUC = 0.263; p = 0.20). We conclude that predictors of poor outcome in childhood IgAN include the following: GFR reduction, nephrotic range proteinuria at onset of disease, and high MEST score in Oxford classification of kidney biopsy. Despite a higher serum IgA/C3 ratio in children with impaired renal function in long-term follow-up, we failed to demonstrate a significant association between this ratio at onset of disease and reduced GFR or persistent proteinuria at follow-up. Thus, IgA/C3 ratio is not a good foreteller of progression of IgA nephropathy in childhood.
More Related Videos
Related Concept Videos
02:07Tumor Progression
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption