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IgA nephropathy: long-term prognosis for pediatric patients
R J Wyatt1, S B Kritchevsky, S Y Woodford
1Department of Pediatrics, University of Tennessee, Memphis 38103, USA.
The Journal of Pediatrics
|December 1, 1995
Summary
Long-term follow-up reveals IgA nephropathy in children has a serious prognosis, similar to adults. Early kidney damage and proteinuria predict poor outcomes, emphasizing continued adult care for pediatric patients.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Immunology
Background:
- IgA nephropathy (IgAN) diagnosed in childhood requires long-term prognosis assessment.
- Understanding long-term outcomes is crucial for managing pediatric IgAN.
Purpose of the Study:
- To determine the long-term prognosis of IgA nephropathy diagnosed in childhood.
- To analyze follow-up data from patients diagnosed over 20 years ago at two centers.
Main Methods:
- Retrospective analysis of 103 pediatric IgAN patients (diagnosed before age 18).
- Collected clinical and renal histologic data at diagnosis and last follow-up.
- Used Kaplan-Meier method to predict kidney survival; 40 patients had >10 years follow-up.
Main Results:
- 14 patients progressed to end-stage renal disease; 3 developed chronic renal insufficiency.
- Histologic severity and proteinuria at biopsy correlated with poor outcomes.
- Predicted kidney survival: 70% at 20 years. Black race and severe histology were risk factors.
Conclusions:
- Pediatric IgA nephropathy has a serious prognosis into adulthood, comparable to adult-onset IgAN.
- Continued medical follow-up is essential for pediatric patients into adulthood, especially with persistent findings.