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IgA nephropathy in children and in adults: two separate entities or the same disease?

Rosanna Coppo1, Thomas Robert2

  • 1Fondazione Ricerca Molinette, Regina Margherita Hospital, Turin, Italy. rosanna.coppo@unito.it.

Journal of Nephrology
|April 22, 2020
PubMed

Insights

IgA nephropathy (IgAN) presents differently in children and adults. Understanding these differences is key to determining if new adult treatments can benefit pediatric patients, potentially preventing long-term kidney damage.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Immunology

Background:

  • IgA nephropathy (IgAN) affects all ages, but management differs between adult and pediatric nephrologists.
  • Pediatric IgAN often presents with hematuria and rarely progresses to end-stage renal disease (ESRD) during childhood.
  • Adult IgAN is typically a progressive glomerular disease with a 30-40% risk of ESRD.

Purpose of the Study:

  • To review similarities and differences in IgA nephropathy (IgAN) across pediatric and adult age groups.
  • To inform the application of new therapeutic strategies for IgAN across the disease spectrum.
  • To determine if IgAN is a single entity or distinct clinical conditions in children and adults.

Main Methods:

  • Comparative review of IgA nephropathy (IgAN) clinical presentations and progression in pediatric versus adult populations.
  • Analysis of risk assessment strategies for both pediatric and adult IgAN cases.
  • Evaluation of the potential applicability of adult therapeutic advancements to pediatric IgAN.

Main Results:

  • IgAN exhibits varied clinical profiles in children and adults, impacting long-term prognosis.
  • Early identification and risk stratification are crucial for appropriate IgAN management in all age groups.
  • Delayed diagnosis in childhood IgAN can lead to irreversible damage manifesting decades later.

Conclusions:

  • IgA nephropathy (IgAN) management requires age-specific considerations due to differing clinical trajectories.
  • Further research is needed to ascertain if IgAN is a unified disease or distinct entities across age groups.
  • Harmonizing treatment approaches based on shared risk factors may improve outcomes for both pediatric and adult IgAN patients.

Keywords:
ChildrenIgA nephropathyProgressionRisk factors

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