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Heterogeneous Renal Trajectories in Pediatric IgA Nephropathy: A Single-Center Experience Highlighting the Dynamic

John Dotis1, Antonia Kondou2, Vasiliki Karava3

  • 1Third Department of Pediatrics, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.

Pediatric Reports
|July 24, 2026
PubMed

Insights

Pediatric IgA nephropathy (IgAN) shows variable kidney function courses, with stability, decline, or improvement observed in children. Further studies are needed to understand progression and histopathology in pediatric IgAN.

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Renal Pathology

Background:

  • Pediatric IgA nephropathy (IgAN) is often presumed to have a favorable early course.
  • However, disease progression in children is variable and not fully understood.
  • The prognostic value of histopathological classifications like MEST-C in pediatric IgAN requires further definition.

Purpose of the Study:

  • To characterize the clinicopathological features of pediatric IgA nephropathy.
  • To describe the early disease course, including histopathological findings and clinical outcomes.
  • To investigate the variability in renal function during the early stages of pediatric IgAN.

Main Methods:

  • Retrospective, single-center study of children with biopsy-confirmed IgAN (2016-2025).
  • Collected clinical, laboratory, and histopathological data, assessed using the Oxford MEST-C classification.
  • Analyzed descriptive follow-up data on estimated glomerular filtration rate (eGFR) until early 2026.

Main Results:

  • Included 14 pediatric patients with heterogeneous presentations.
  • Mesangial hypercellularity (100%), endocapillary hypercellularity (78.6%), and segmental sclerosis (57.1%) were common, indicating active lesions.
  • Over a median 5-year follow-up, renal function was stable (57.1%), declined (21.4%), or improved (14.3%). One patient experienced severe acute kidney injury with full recovery.

Conclusions:

  • Pediatric IgAN exhibits variable renal function trajectories, including stability, decline, and partial recovery.
  • Findings are descriptive and hypothesis-generating due to the small cohort size.
  • Longitudinal monitoring in larger pediatric cohorts is recommended to better understand IgAN progression.
Abstract

Keywords:
IgA nephropathyMEST-C classificationchronic kidney diseasedisease progressionkidney biopsypediatric nephrologyproteinuriarenal function

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