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Prognosis and predictive factors in pediatric IgA nephropathy

Wenpei Liang1, Yonghua He1, Xueqing Ma1

  • 1Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, 430030, China.

Pediatric Nephrology (Berlin, Germany)
|November 12, 2025
PubMed

Insights

IgA nephropathy (IgAN) in children shows slow progression. While many achieve remission, recurrence is common, highlighting the need for long-term monitoring and better predictive tools for pediatric kidney disease.

Area of Science:

  • Pediatric Nephrology
  • Glomerular Diseases
  • Chronic Kidney Disease

Background:

  • IgA nephropathy (IgAN) is a primary cause of chronic kidney disease (CKD) in children.
  • Identifying prognostic markers is crucial for managing pediatric IgAN and preventing kidney failure.

Purpose of the Study:

  • Investigate predictors of poor prognosis in pediatric IgAN.
  • Analyze remission and relapse patterns and their associated factors.
  • Evaluate the impact of remission on long-term outcomes.

Main Methods:

  • Retrospective cohort study of 224 children with biopsy-proven IgAN and ≥3 years follow-up.
  • Defined poor prognosis as persistent eGFR <90 mL/min/1.73 m² for ≥3 months.
  • Utilized logistic regression, ROC analysis, and linear mixed-effects models for prediction and eGFR slope evaluation.

Main Results:

  • Independent risk factors for poor prognosis included male sex, older age, specific Oxford lesions (E1, S1), absence of gross hematuria, and lack of proteinuria remission.
  • Higher birth weight was protective; eGFR slope was influenced by age, gross hematuria, and proteinuria remission.
  • Complete kidney remission occurred in 70.98%, with a 60.38% recurrence rate. Predictors included antecedent infection and IgM deposition; risk factors included prolonged disease duration and tubular casts.

Conclusions:

  • Pediatric IgAN exhibits slow progression over 5 years with high remission rates but significant recurrence.
  • Findings underscore the necessity for extended follow-up and enhanced predictive models for pediatric IgAN management.
Abstract

Keywords:
ChildrenIgA nephropathyKidney complete remissionPoor prognosis

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