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Pediatric Nephrology

, Volume 28, Issue 1, pp 71–76 | Cite as

Spontaneous remission in children with IgA nephropathy

  • Yuko Shima
  • Koichi NakanishiEmail author
  • Taketsugu Hama
  • Hironobu Mukaiyama
  • Hiroko Togawa
  • Mayumi Sako
  • Hiroshi Kaito
  • Kandai Nozu
  • Ryojiro Tanaka
  • Kazumoto Iijima
  • Norishige Yoshikawa
Original Article

Abstract

Background

Some patients with IgA nephropathy (IgAN) achieve spontaneous remission even when not receiving medication. However, details on such remissions remain unknown. The aim of our study was to clarify this information in the clinical setting of childhood IgAN with minor glomerular abnormalities or focal mesangial proliferation (MGA/FMP).

Methods

This study was a retrospective analysis of 96 children with MGA/FMP who did not receive medication from among the 555 patients with newly diagnosed childhood IgAN treated between January 1972 and December 2000. The Kaplan–Meier method and Cox proportional hazard model were used for the analysis.

Results

Of the 96 pediatric patients who did not receive medication, 57 (59.4 %) achieved spontaneous remission. The cumulative spontaneous remission rates among these patients were 57.5  and 77.4 % at 5 and 10 years, respectively, from onset. The mean time from onset to remission was 5.9 ± 0.4 years. Clinical and histological findings were similar between the remission and non-remission groups. Of the 57 patients with spontaneous remissions, ten (17.5 %) also developed a recurrence of urinary abnormalities. The cumulative recurrence-free rates were 79.9 and 67.9 % at 5 and 10 years, respectively, after remission.

Conclusions

The spontaneous remission rate in childhood IgAN with MGA/FMP was higher than expected. Our results suggest that physicians should consider the potential for spontaneous remission and refrain from very aggressive treatment in IgAN patients with MGA/FMP.

Keywords

Minor glomerular abnormality Focal mesangial proliferation Recurrence Kaplan–Meier method Cox proportional hazard model 

Notes

Acknowledgments

The authors wish to thank all of the participants and attending physicians for their contributions.

Disclosures

None.

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Copyright information

© IPNA 2012

Authors and Affiliations

  • Yuko Shima
    • 1
  • Koichi Nakanishi
    • 1
    Email author
  • Taketsugu Hama
    • 1
  • Hironobu Mukaiyama
    • 1
  • Hiroko Togawa
    • 1
  • Mayumi Sako
    • 2
  • Hiroshi Kaito
    • 3
  • Kandai Nozu
    • 3
  • Ryojiro Tanaka
    • 4
  • Kazumoto Iijima
    • 3
  • Norishige Yoshikawa
    • 1
  1. 1.Department of PediatricsWakayama Medical UniversityWakayama CityJapan
  2. 2.Division for Clinical TrialsNational Center for Child Health and DevelopmentTokyoJapan
  3. 3.Department of PediatricsKobe University Graduate School of MedicineKobeJapan
  4. 4.Department of NephrologyHyogo Prefectural Kobe Children’s HospitalKobeJapan

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