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著者: Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Rosanna Coppo, Stéphan Troyanov, Roberta Camilla, Ronald J Hogg, Daniel C Cattran, H Terence Cook, John Feehally, Ian S D Roberts, Alessandro Amore, Charles E Alpers, Jonathan Barratt, Francois Berthoux, Stephen Bonsib, Jan A Bruijn, Vivette D'Agati, Giuseppe D'Amico, Steven N Emancipator, Francesco Emma, Franco Ferrario, Fernando C Fervenza, Sandrine Florquin, Agnes B Fogo, Colin C Geddes, Hermann J Groene, Mark Haas, Andrew M Herzenberg, Prue A Hill, Stephen I Hsu, J Charles Jennette, Kensuke Joh, Bruce A Julian, Tetsuya Kawamura, Fernand M Lai, Lei S Li, Philip K Li, Zhi H Liu, Sergio Mezzano, F Paolo Schena, Yasuhiko Tomino, Patrick D Walker, Haiyan Wang, Jan J Weening, Norishige Yoshikawa, Hong Zhang
雑誌名: Kidney Int. 2010 May;77(10):921-7. doi: 10.1038/ki.2010.43. Epub 2010 Mar 3.
Abstract/Text
To study the predictive value of biopsy lesions in IgA nephropathy in a range of patient ages we retrospectively analyzed the cohort that was used to derive a new classification system for IgA nephropathy. A total of 206 adults and 59 children with proteinuria over 0.5 g/24 h/1.73 m(2) and an eGFR of stage-3 or better were followed for a median of 69 months. At the time of biopsy, compared with adults children had a more frequent history of macroscopic hematuria, lower adjusted blood pressure, and higher eGFR but similar proteinuria. Although their outcome was similar to that of adults, children had received more immunosuppressants and achieved a lower follow-up proteinuria. Renal biopsies were scored for variables identified by an iterative process as reproducible and independent of other lesions. Compared with adults, children had significantly more mesangial and endocapillary hypercellularity, and less segmental glomerulosclerosis and tubulointerstitial damage, the four variables previously identified to predict outcome independent of clinical assessment. Despite these differences, our study found that the cross-sectional correlation between pathology and proteinuria was similar in adults and children. The predictive value of each specific lesion on the rate of decline of renal function or renal survival in IgA nephropathy was not different between children and adults.
PMID 20200498 Kidney Int. 2010 May;77(10):921-7. doi: 10.1038/ki.2010.43. Epub 2010 Mar 3.
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