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IgAN Across the Age Spectrum: The Pediatric Perspective
Licia Peruzzi1, Rosanna Coppo2
1Pediatric Nephrology Unit, Regina Margherita Children's Hospital, University of Turin, Italy.
Insights
IgA nephropathy (IgAN) shows varied progression in children and adults. Recent insights focus on risk profiles to guide tailored treatment, avoiding overtreatment in benign cases and ensuring aggressive therapy for progressive IgAN.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Immunology
Background:
- IgA nephropathy (IgAN) exhibits diverse clinical presentations and disease trajectories across different age groups.
- Comparing IgAN incidence and progression between children and adults is challenging due to variations in kidney biopsy protocols and national guidelines.
- Recent research emphasizes individualized risk assessment at the time of kidney biopsy or during follow-up to personalize IgAN management.
Purpose of the Study:
- To review recent findings on the similarities and differences in IgA nephropathy (IgAN) across the pediatric and adult age spectrum.
- To highlight prognostic predictors of IgAN progression in both children and adults.
- To provide critical insights for optimizing treatment decisions for IgAN patients of all ages.
Main Methods:
- Literature review of recent studies on IgA nephropathy (IgAN) in pediatric and adult populations.
- Analysis of prognostic factors influencing IgAN progression.
- Comparative assessment of IgAN characteristics and outcomes across different age groups.
Main Results:
- IgA nephropathy (IgAN) demonstrates age-specific differences in presentation and natural history.
- Individualized risk profiling at kidney biopsy and during follow-up is crucial for guiding IgAN treatment strategies.
- Identifying prognostic predictors aids in distinguishing between benign and progressive forms of IgAN, informing therapeutic intensity.
Conclusions:
- Understanding age-related nuances in IgA nephropathy (IgAN) is essential for effective clinical management.
- Prognostic predictors play a key role in tailoring treatment approaches for IgAN across the lifespan.
- Personalized risk assessment and targeted therapies can improve outcomes for both pediatric and adult IgAN patients.
Abstract:
IgA nephropathy (IgAN) presents with different expressions and natural histories across ages. The direct comparison of incidence and progression of IgAN in children and adults is difficult due to different policies for performing kidney biopsy in different ages and countries. In the past decade the focus has been on assessing the individual risk profile at kidney biopsy or after 1 year of follow-up in children and adults. This would help avoid overtreatment and unnecessary drug exposure in benign cases of IgAN, and promptly initiate an aggressive therapy in progressive ones. This issue is particularly relevant in children. This review addresses some recent insights into the similarities and differences of IgAN across the age spectrum, with a particular focus on the prognostic predictors of progression in children and in adults, aiming at offering some critical elements useful for treatment choices for IgAN across ages.
