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Alteration of lung diffusion capacity in IgA nephropathy
S Ravilly1, M Chaussain, J L Iniguez
1Department of Paediatrics, Hôpital Saint Vincent de Paul, Paris, France.
Archives of Disease in Childhood
|March 1, 1996
Summary
Lung function, specifically lung transfer for carbon monoxide (TLCO), is significantly reduced during active IgA nephropathy phases. This non-invasive test may aid in diagnosing IgA nephropathy in children with hematuria.
Area of Science:
- Nephrology
- Pulmonology
- Pediatrics
Background:
- IgA nephropathy (IgAN) is a common glomerular kidney disease.
- The relationship between IgAN activity and lung function is not well understood.
Purpose of the Study:
- To investigate the correlation between lung transfer for carbon monoxide (TLCO) and the clinical phases of IgA nephropathy in children.
Main Methods:
- Respiratory function, including TLCO, was assessed in 12 children diagnosed with IgAN via renal biopsy.
- Tests were conducted during acute exacerbations/hematuria and during hematuria-free periods.
Main Results:
- TLCO was significantly reduced (mean 64% of expected) during hematuria or in the month following gross hematuria.
- Lung volumes and blood gases remained normal; minor interstitial lung changes were noted in most patients.
- TLCO remained low in some patients >3 months post-hematuria, independent of proteinuria or biopsy findings.
- A significant difference (p < 0.01) was observed in TLCO between acute/recent hematuria phases and periods >3 months after gross hematuria.
Conclusions:
- Decreased TLCO during active IgAN phases likely results from immune complex-mediated damage to the lung alveolar-capillary membrane.
- TLCO measurement is a potentially valuable, non-invasive tool for diagnosing IgAN in children presenting with hematuria.