Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy
Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulopathies diagnosed in children and adolescents. This study aimed to evaluate the clinical features in and outcomes of pediatric IgAN over the last 30 years. Patients who were diagnosed before age of 18 at 20 centers in Kor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/7/2058 |
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| author | Jin-Soon Suh Kyung Mi Jang Hyesun Hyun Myung Hyun Cho Joo Hoon Lee Young Seo Park Jae Hyuk Oh Ji Hong Kim Kee Hwan Yoo Woo Yeong Chung Seong Heon Kim Keehyuck Kim Dae Yeol Lee Jung Won Lee Min Hyun Cho Hyewon Park Ja Wook Koo Kyoung Hee Han Eun Mi Yang Keum Hwa Lee Jae Il Shin Heeyeon Cho Kyo Soon Kim Il-Soo Ha Yong Hoon Park Hee Gyung Kang |
| author_facet | Jin-Soon Suh Kyung Mi Jang Hyesun Hyun Myung Hyun Cho Joo Hoon Lee Young Seo Park Jae Hyuk Oh Ji Hong Kim Kee Hwan Yoo Woo Yeong Chung Seong Heon Kim Keehyuck Kim Dae Yeol Lee Jung Won Lee Min Hyun Cho Hyewon Park Ja Wook Koo Kyoung Hee Han Eun Mi Yang Keum Hwa Lee Jae Il Shin Heeyeon Cho Kyo Soon Kim Il-Soo Ha Yong Hoon Park Hee Gyung Kang |
| author_sort | Jin-Soon Suh |
| collection | DOAJ |
| description | Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulopathies diagnosed in children and adolescents. This study aimed to evaluate the clinical features in and outcomes of pediatric IgAN over the last 30 years. Patients who were diagnosed before age of 18 at 20 centers in Korea were evaluated retrospectively. Of the 1154 patients (768 males, 386 females) with a median follow-up of 5 years, 5.6% (<i>n</i> = 65) progressed to stage 3–5 chronic kidney disease (CKD). The 10- and 20-year CKD-free survival rates were 91.2% and 75.6%, respectively. Outcomes did not differ when comparing those in Korea who were diagnosed prior to versus after the year 2000. On multivariate analysis, combined asymptomatic hematuria and proteinuria as presenting symptoms and decreased renal function at the time of biopsy were associated with progression to CKD, while remission of proteinuria was negatively associated with this outcome. Patients who presented with gross hematuria or nephrotic syndrome tended toward positive outcomes, especially if they ultimately achieved remission. While remission of proteinuria might imply that the disease is inherently less aggressive, it also can be achieved by management. Therefore, more aggressive management might be required for pediatric-onset IgAN. |
| first_indexed | 2024-03-10T18:47:15Z |
| format | Article |
| id | doaj.art-3821dba7d83b4d3cbc853182ad378e31 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T18:47:15Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3821dba7d83b4d3cbc853182ad378e312023-11-20T05:25:53ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0197205810.3390/jcm9072058Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA NephropathyJin-Soon Suh0Kyung Mi Jang1Hyesun Hyun2Myung Hyun Cho3Joo Hoon Lee4Young Seo Park5Jae Hyuk Oh6Ji Hong Kim7Kee Hwan Yoo8Woo Yeong Chung9Seong Heon Kim10Keehyuck Kim11Dae Yeol Lee12Jung Won Lee13Min Hyun Cho14Hyewon Park15Ja Wook Koo16Kyoung Hee Han17Eun Mi Yang18Keum Hwa Lee19Jae Il Shin20Heeyeon Cho21Kyo Soon Kim22Il-Soo Ha23Yong Hoon Park24Hee Gyung Kang25Departments of Pediatrics, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, KoreaYeungnam University Hospital, Daegu 42415, KoreaSt. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, KoreaHallym University Sacred Heart Hospital, Anyang 14068, KoreaAsan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul 05505, KoreaAsan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul 05505, KoreaAjou University Hospital, School of Medicine, Suwon 16499, KoreaDepartment of Pediatrics, Yonsei University College of Medicine, Seoul 03722, KoreaKorea University Guro Hospital, Seoul 08308, KoreaBusan Paik Hospital, College of Medicine, Inje University, Busan 47392, KoreaPusan National University Children’s Hospital, Yangsan 50612, KoreaNational Health Insurance Service Ilsan Hospital, Goyang 10444, KoreaJeonbuk National University Hospital, Jeonju 54907, KoreaEwha Womans University Seoul Hospital, Seoul 07804, KoreaSchool of Medicine, Kyungpook National University, Daegu 41944, KoreaSeoul National University Bundang Hospital, Seongnam 13620, KoreaInje University Sanggye Paik Hospital, Seoul 01757, KoreaJeju National University School of Medicine, Jeju 63243, KoreaChonnam National University Hospital and Medical School, Hwasun 58128, KoreaDepartment of Pediatrics, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Pediatrics, Yonsei University College of Medicine, Seoul 03722, KoreaSamsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaKonkuk University Hospital, Seoul 05029, KoreaSeoul National University College of Medicine and Seoul National University Children’s Hospital, Seoul 03080, KoreaYeungnam University Hospital, Daegu 42415, KoreaSeoul National University College of Medicine and Seoul National University Children’s Hospital, Seoul 03080, KoreaImmunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulopathies diagnosed in children and adolescents. This study aimed to evaluate the clinical features in and outcomes of pediatric IgAN over the last 30 years. Patients who were diagnosed before age of 18 at 20 centers in Korea were evaluated retrospectively. Of the 1154 patients (768 males, 386 females) with a median follow-up of 5 years, 5.6% (<i>n</i> = 65) progressed to stage 3–5 chronic kidney disease (CKD). The 10- and 20-year CKD-free survival rates were 91.2% and 75.6%, respectively. Outcomes did not differ when comparing those in Korea who were diagnosed prior to versus after the year 2000. On multivariate analysis, combined asymptomatic hematuria and proteinuria as presenting symptoms and decreased renal function at the time of biopsy were associated with progression to CKD, while remission of proteinuria was negatively associated with this outcome. Patients who presented with gross hematuria or nephrotic syndrome tended toward positive outcomes, especially if they ultimately achieved remission. While remission of proteinuria might imply that the disease is inherently less aggressive, it also can be achieved by management. Therefore, more aggressive management might be required for pediatric-onset IgAN.https://www.mdpi.com/2077-0383/9/7/2058childrenIgA nephropathylong-term outcomeremission of proteinuria |
| spellingShingle | Jin-Soon Suh Kyung Mi Jang Hyesun Hyun Myung Hyun Cho Joo Hoon Lee Young Seo Park Jae Hyuk Oh Ji Hong Kim Kee Hwan Yoo Woo Yeong Chung Seong Heon Kim Keehyuck Kim Dae Yeol Lee Jung Won Lee Min Hyun Cho Hyewon Park Ja Wook Koo Kyoung Hee Han Eun Mi Yang Keum Hwa Lee Jae Il Shin Heeyeon Cho Kyo Soon Kim Il-Soo Ha Yong Hoon Park Hee Gyung Kang Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy Journal of Clinical Medicine children IgA nephropathy long-term outcome remission of proteinuria |
| title | Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy |
| title_full | Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy |
| title_fullStr | Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy |
| title_full_unstemmed | Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy |
| title_short | Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy |
| title_sort | remission of proteinuria may protect against progression to chronic kidney disease in pediatric onset iga nephropathy |
| topic | children IgA nephropathy long-term outcome remission of proteinuria |
| url | https://www.mdpi.com/2077-0383/9/7/2058 |
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