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Pediatric Nephrology

, Volume 7, Issue 2, pp 123–129 | Cite as

Follow-up of renal function and urinary protein excretion in childhood IgA nephropathy

  • Ulla B. Berg
  • Ulla C. Widstam-Attorps
Original Article

Abstract

Renal haemodynamics and urinary protein excretion (UPE) were investigated in 36 patients with IgA nephropathy more than 3 years after renal biopsy (mean interval 6.3±0.5 years). At follow-up, 39% of patients had a reduced glornerular filtration rate (GFR) and 11% end-stage renal failure. Twenty-five percent had albuminuria, and a further 25% microalbuminuria. All albuminuric patients had GFRs below the mean, and 78% of the albuminurics had a reduced GFR. However, non-albuminurics also had decreased GFRs and GFR tended to fall with the duration of the disease in this group of patients. On comparing the histological changes in the biopsies with haemodynamic and UPE studies performed 6 years later, we found significant correlations between the extent of segmental glomerular sclerosis and GFR, effective renal plasma flow, urinary albumin and IgG excretion, respectively. Histological grading correlated with the same variables. Of the 4 uraemic patients, 2 were nephrotic at presentation, while the other 2 had a nephritic onset of disease and later developed heavy proteinuria. Three of their biopsies showed ≥10% segmental glomerulosclerosis. Juvenile IgA nephropathy is not a harmless disease. Our results indicate that these children should be carefully monitored with adequate GFR measurements and urine protein analyses.

Key words

IgA nephropathy Glomerular filtration rate Effective renal plasma flow Albuminuria Segmental sclerosis End-stage renal failure 

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Copyright information

© IPNA 1993

Authors and Affiliations

  • Ulla B. Berg
    • 1
  • Ulla C. Widstam-Attorps
    • 1
  1. 1.Departments of Paediatrics and Renal Medicine, Karolinska InstituteHuddinge University HospitalHuddingeSweden

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