Clinical and Experimental Nephrology

, Volume 19, Issue 6, pp 1149–1156 | Cite as

Long-term morbidity of IgA nephropathy in children evaluated with newly proposed remission criteria in Japan

  • Shoko Matsushita
  • Kenji IshikuraEmail author
  • Shojiro Okamoto
  • Yusuke Okuda
  • Yoshinobu Nagaoka
  • Ryoko Harada
  • Riku Hamada
  • Tomoyuki Sakai
  • Yuko Hamasaki
  • Hiroshi Hataya
  • Takashi Ando
  • Kentaro Ogata
  • Masataka Honda
Original Article



The long-term outcome of pediatric IgA nephropathy (IgAN) is unclear. Objective IgAN remission criteria were proposed by the Japanese Society of Nephrology in 2013.


Children with newly developed IgAN followed for >5 years were analyzed. They were divided into two groups based on histological findings at initial kidney biopsy: the focal mesangial proliferation group (Focal group) and diffuse mesangial proliferation group (Diffuse group). The primary outcome was the remission rate according to the newly proposed IgAN remission criteria.


The patients comprised 53 children (31 boys; mean age at IgAN onset, 10.0 years). The Focal and Diffuse groups comprised 21 and 32 patients, respectively. No significant differences in patient characteristics were found between the groups except for steroid administration. The median follow-up period from onset was 9.9 years. Sixteen patients in the Diffuse group and 10 in the Focal group had not achieved remission at the last observation. Patient conditions 2 years after the initial treatment were almost identical to those at the last observation. Multivariate analysis revealed that proteinuria, particularly <0.5 g/g Cr at 2 years, was significantly associated with remission at the last observation regardless of proteinuria status at the start of treatment.


Pediatric IgAN has a prolonged course that is longer than expected regardless of severity at diagnosis. Patient conditions 2 years after initial treatment predicted their conditions at the last observation. Although the final renal function of these patients is presently unclear, children with IgAN should be followed beyond adolescence and further into adulthood.


IgA nephropathy Remission criteria Children 



The authors would like to thank Dr. Emi Kawaguchi of Tokyo Metropolitan Children’s Medical Center for her support in preparation of the manuscript. The authors also wish to thank Angela Morben, DVM, ELS, of Edanz Group Ltd, for providing editorial language support in the preparation of the manuscript. This work was partly supported by a Health and Labour Sciences Research Grant for Research on Rare and Intractable Diseases from the Ministry of Health, Labour and Welfare, Japan (H26-nanchitou(nan)-ippan-036).

Conflict of interest

The authors have declared that no conflict of interest exists.


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Copyright information

© Japanese Society of Nephrology 2015

Authors and Affiliations

  • Shoko Matsushita
    • 1
    • 2
  • Kenji Ishikura
    • 1
    Email author
  • Shojiro Okamoto
    • 3
  • Yusuke Okuda
    • 1
    • 4
  • Yoshinobu Nagaoka
    • 1
    • 5
  • Ryoko Harada
    • 1
  • Riku Hamada
    • 1
  • Tomoyuki Sakai
    • 4
  • Yuko Hamasaki
    • 6
  • Hiroshi Hataya
    • 1
  • Takashi Ando
    • 7
  • Kentaro Ogata
    • 8
  • Masataka Honda
    • 1
  1. 1.Department of NephrologyTokyo Metropolitan Children’s Medical CenterFuchuJapan
  2. 2.Division of AllergyTokyo Metropolitan Children’s Medical CenterFuchuJapan
  3. 3.Department of PediatricsTokai University Hachioji HospitalHachiojiJapan
  4. 4.Department of PediatricsShiga University of Medical ScienceOtsuJapan
  5. 5.Department of PediatricsNational Hospital Organization, Hokkaido Medical CenterSapporoJapan
  6. 6.Department of Pediatric NephrologyToho University Faculty of MedicineTokyoJapan
  7. 7.Japan Clinical Research Support UnitBunkyo-kuJapan
  8. 8.Division of PathologyFederation of National Public Service Personnel Mutual Aid Associations, Tachikawa HospitalTachikawaJapan

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