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Differences in response to treatment in children with severe IgA nephropathy according to patient age
Yukihiko Kawasaki1,2, Yohei Kume2, Atsushi Ono2
1Fukushima Medical University, Regional Medical Support Center.
Insights
Children with IgA nephropathy (IgAN) diagnosed at age 14 or older show poorer treatment response and higher risk of persistent kidney disease. This highlights the need for careful management in older pediatric IgAN patients.
Area of Science:
- Pediatric Nephrology
- Immunology
- Renal Pathology
Background:
- IgA nephropathy (IgAN) is a common cause of glomerulonephritis in children.
- Treatment response in pediatric IgAN can vary, but age-related differences are not fully understood.
Purpose of the Study:
- To investigate if the age of onset influences treatment outcomes in children with severe IgA nephropathy.
- To compare clinical features, histological findings, and prognosis based on age groups.
Main Methods:
- Retrospective analysis of 44 children with severe IgAN.
- Patients categorized into three groups based on age at onset: <11 years, 12-13 years, and >14 years.
- Clinical data, serum IgA, urinary protein excretion, and MESTCG scores were analyzed.
Main Results:
- Children aged >14 years (Group 3) exhibited higher urinary protein excretion and serum IgA levels compared to younger groups.
- Group 3 also showed higher MESTCG scores and a greater incidence of persistent nephropathy or renal insufficiency.
- These findings suggest a less favorable prognosis in older children with IgAN.
Conclusions:
- Pediatric patients with IgA nephropathy diagnosed at age 14 or older may have a poorer response to treatment.
- Close monitoring for treatment response and relapse is crucial for older children diagnosed with IgAN.
Aim:
To clarify whether the response to treatment of IgA nephropathy (IgAN) differs depending on patient age, we examined the response to treatment according to age of onset in children with IgAN.
Methods:
We collected data for 44 children with severe IgAN. The children were retrospectively divided into three groups based on their age at disease onset. Group 1 consisted of 24 children under 11 years old, group 2 consisted of 9 children aged 12 to 13 years, and group 3 consisted of 11 children aged over 14 years old. The clinical features and prognosis were analyzed for each group.
Results:
The urinary protein excretion and serum IgA values in group 3 were higher than those in groups 1 and 2 at the most recent follow up, and histological findings showed that the MESTCG scores in group 3 were higher than those in group 1. Furthermore, the incidence of patients with persistent nephropathy or renal insufficiency in group 3 was higher than those in groups 1 and 2.
Conclusions:
Patients aged 14 years and older with IgAN may respond poorly to treatment compared with those younger than 14 years old. Therefore, care must be taken regarding response to treatment and relapse when treating older children.
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