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Pediatric Nephrology

, Volume 21, Issue 9, pp 1266–1273 | Cite as

Long-term outcome 19 years after childhood IgA nephritis: a retrospective cohort study

  • Jaana Ronkainen
  • Marja Ala-Houhala
  • Helena Autio-Harmainen
  • Timo Jahnukainen
  • Olli Koskimies
  • Jussi Merenmies
  • Jukka Mustonen
  • Timo Örmälä
  • Juha Turtinen
  • Matti Nuutinen
Original Article

Abstract

We evaluated the natural long-term outcome after childhood IgA nephritis. Altogether 55 patients with biopsy-proven IgA nephritis were identified, 37 (67%) responded to the health questionnaire and 31 (56%) participated in the medical examination after a mean follow-up of 18.7 years (SD 6.2; range 8.5–29.8). The results of medical examination, onset data and the re-analysis of original biopsies of 31 participants were used when analyzing the predictive factors for persistent nephropathy, i.e. constant proteinuria/hematuria or end-stage renal disease (ESRD). All patients’ medical history data were obtained from regional hospitals and renal survival data from the national kidney register. Six (11%) of the 55 identified patients had developed ESRD. Sixteen (52%) of the 31 participants were not attending for regular follow-up visits after the acute phase. Twenty-two (71%) had renal symptoms and 12 (39%) were receiving drugs for hypertension/proteinuria at their latest follow-up visit. The chronicity index and total biopsy score in the first renal biopsy were higher in patients with persistent nephropathy or ESRD than in those without (p=0.022 and p=0.014, respectively). Nine (69%) of the 13 subjects who had been over 16 years of age at diagnosis had persistent nephropathy or ESRD, compared with 4 (22%) of the 18 subjects who had been under 16 years of age (relative risk 3.1, 95% CI 1.2–8.0). Pregnancy complications were common: 12 (55%) of the 22 pregnancies had been complicated by proteinuria and/or hypertension, and the prematurity rate was 30%. Long-term follow-up during adulthood is needed even after mild childhood IgA nephritis, especially in women during and after pregnancy.

Keywords

End-stage renal disease Renal impairment Hypertension IgA glomerulonephritis Toxemia Pregnancy 

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Jaana Ronkainen
    • 1
  • Marja Ala-Houhala
    • 2
  • Helena Autio-Harmainen
    • 3
  • Timo Jahnukainen
    • 4
  • Olli Koskimies
    • 5
  • Jussi Merenmies
    • 5
  • Jukka Mustonen
    • 6
  • Timo Örmälä
    • 7
  • Juha Turtinen
    • 1
  • Matti Nuutinen
    • 1
  1. 1.Department of Pediatrics and AdolescenceOulu University HospitalOuluFinland
  2. 2.Department of PediatricsTampere University HospitalTampereFinland
  3. 3.Department of PathologyOulu University HospitalOuluFinland
  4. 4.Department of PediatricsTurku University HospitalTurkuFinland
  5. 5.Hospital of Children and AdolescentsUniversity of HelsinkiHelsinkiFinland
  6. 6.Department of Internal MedicineTampere University HospitalTampereFinland
  7. 7.Department of PediatricsUniversity Hospital of KuopioKuopioFinland

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