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

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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.

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Authors and Affiliations

  1. Department of Pediatrics and Adolescence, Oulu University Hospital, P.O. Box 23, 90029, Oulu, Finland

    Jaana Ronkainen, Juha Turtinen & Matti Nuutinen

  2. Department of Pediatrics, Tampere University Hospital, Tampere, Finland

    Marja Ala-Houhala

  3. Department of Pathology, Oulu University Hospital, Oulu, Finland

    Helena Autio-Harmainen

  4. Department of Pediatrics, Turku University Hospital, Turku, Finland

    Timo Jahnukainen

  5. Hospital of Children and Adolescents, University of Helsinki, Helsinki, Finland

    Olli Koskimies & Jussi Merenmies

  6. Department of Internal Medicine, Tampere University Hospital, Tampere, Finland

    Jukka Mustonen

  7. Department of Pediatrics, University Hospital of Kuopio, Kuopio, Finland

    Timo Örmälä

Authors
  1. Jaana Ronkainen
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  2. Marja Ala-Houhala
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  3. Helena Autio-Harmainen
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  4. Timo Jahnukainen
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  5. Olli Koskimies
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  6. Jussi Merenmies
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  7. Jukka Mustonen
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  8. Timo Örmälä
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  9. Juha Turtinen
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  10. Matti Nuutinen
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Correspondence to Matti Nuutinen.

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Ronkainen, J., Ala-Houhala, M., Autio-Harmainen, H. et al. Long-term outcome 19 years after childhood IgA nephritis: a retrospective cohort study. Pediatr Nephrol 21, 1266–1273 (2006). https://doi.org/10.1007/s00467-006-0163-x

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  • DOI: https://doi.org/10.1007/s00467-006-0163-x

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