Correlation Between Clinical and Pathological Prognositic Factors of IgA Nephropathy in Children

ABSTRACT

PURPOSE: Clinical and pathological prognostic factors of idiopathic IgA nephropathy have been reported, but mostly in adults and a few in children. Especially studies about correlation between those factors are very rare. METHODS: We studied 58 children patients who were hospitalized to our clinics and diagnosed as IgA nephropathy by renal biopsy from Jan. 1989 to Jun 1996. They got divided into several clinical groups, which are heavy proteinuria group (group A), asymptomatic urinary abnormalities group proteinuria and/or microscopic hematuria (group B), and recurrent gross hematuria group (group C). They are also divided into younger group (younger than 10 years of age) and older group (older than 10 years og age). We compared their pathological findings of bad prognosis, if they have, in different clinical groups. RESULTS: Group A had most pathological factors of bad prognosis such as higher Meadow grade, crescent formation, necrosis, glomerulosclerosis, tubular atrophy, interstitial fibrosis, two or more kinds of immune deposit except IgA, high frequency of electron dense deposits of glomerular capillary wall. Group B treded to have some poor prognostic factors such as tubular atrophy and interstitial fibrosis. in terms of age groups, older group was more apt to be heavily proteinuric than younger group, have such pathological factors of poor prognosis that group A had. CONCLUSION: Heavy proteinuria and relative old age in childhood IgA nephropathy, considered clinically poor prognostic, appears significantly correlated with pathologically poor prognostic factors.