DOI: https://doi.org/10.22141/2224-0551.14.2.2019.165548

Immunoglobulin A nephropathy in children: a review of the literature and own data

I.A. Kazyra, A.V. Sukala

Abstract


Background. Immunoglobulin A (IgA) nephropathy is the most common primary chronic glomerulopathy in adults and children. It is believed that in childhood it has a benign course, but in adults it ranks first among all glomerulopathies as a cause of end-stage renal disease at a young age. The purpose of the study was analysis of literature data, clinical, immunopathological and morphological changes in IgA nephropathy to identify children at high risk of disease progression. Materials and methods. The study included 53 patients with IgA nephropathy (36 boys, 17 girls) aged from 6 to 17 years, who were under observation at the Republican Center for Pediatric Nephrology and Renal Replacement Therapy in Minsk. Inclusion criteria: predominance of dominant/co-dominant mesangial IgA deposits in kidney specimen according to MEST-C 2016 classification. The duration of follow-up ranged from 13 months to 6 years. Results. In children with IgA nephropathy, the concentration of aberrant deGal-IgA1 was significantly higher as compared to the patients with Henoch-Schonlein nephritis and healthy individuals (p < 0.001). The risk of rapid progression and onset of end-stage renal disease is inc reased in patients with hypertension, proteinuria over 0.5 g/day, a decrease in estimated glomerular filtration rate less than 60 ml/min, the presence of segmental sclerosis, tubular atrophy, interstitial fibrosis, fibrous and fibrocellular crescents, a large number of IgA deposits in combination with C3 in the biopsy specimen. Conclusions. In childhood in most cases, IgA nephropathy has a low rate of progression and does not lead to a complete loss of kidney function.


Keywords


IgA nephropathy; children; factors of progression

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