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IgA Nephropathy in Children: A Multicenter Study in Poland

  • M. Mizerska-WasiakEmail author
  • A. Turczyn
  • A. Such
  • K. Cichoń-Kawa
  • J. Małdyk
  • M. Miklaszewska
  • J. Pietrzyk
  • A. Rybi-Szumińska
  • A. Wasilewska
  • A. Firszt-Adamczyk
  • R. Stankiewicz
  • M. Szczepańska
  • B. Bieniaś
  • M. Zajączkowska
  • A. Pukajło-Marczyk
  • D. Zwolińska
  • K. Siniewicz-Luzeńczyk
  • M. Tkaczyk
  • K. Gadomska-Prokop
  • R. Grenda
  • U. Demkow
  • M. Pańczyk-Tomaszewska
Chapter
Part of the Advances in Experimental Medicine and Biology book series

Abstract

IgA nephropathy (IgAN) is the most common form of glomerulonephritis in pediatric population. The clinical presentation of the disease in children ranges from microscopic hematuria to end-stage kidney disease. The aim of the study was to retrospectively assess clinical and kidney biopsy features in children with IgAN. We assessed a cohort of 140 children, 88 boys, 52 girls with the diagnosis of IgAN in the period of 2000–2015, entered into the national Polish pediatric IgAN registry. The assessment included the following: proteinuria, hematuria, glomerular filtration rate (GFR), arterial blood pressure, and the renal pathological changes according to the Oxford classification and crescents formation, as modifiable and unmodifiable risk factors. The incidence of IgAN in Poland was set at 9.3 new cases per year. The mean age at onset of IgAN was 11.9 ± 4.3 years, and the most common presentation of the disease was the nephritic syndrome, recognized in 52 % of patients. Kidney biopsy was performed, on average, 1.3 ± 2.0 years after onset of disease. Based on the ROC analysis, a cut-off age at onset of disease for GFR <90 mL/min/1.73 m2 (risk factor of progression) was calculated as 13.9 years. Unmodifiable lesions: segmental sclerosis, tubular atrophy/interstitial fibrosis (S1, T1-2) in the Oxford classification and crescents in kidney biopsy were significantly more common in Gr 1 (>13.9 years) compared with Gr 2 (<13.9 years), despite a significantly shorter time to kidney biopsy in the former. We conclude that IgAN in children may be an insidious disease. A regular urine analysis, especially after respiratory tract infections, seems the best way for an early detection of the disease.

Keywords

Children Glomerulonephritis Hematuria IgA nephropathy IgA protein Kidney Proteinuria Respiratory infection ROC analysis 

Notes

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • M. Mizerska-Wasiak
    • 1
    Email author
  • A. Turczyn
    • 1
  • A. Such
    • 1
  • K. Cichoń-Kawa
    • 1
  • J. Małdyk
    • 2
  • M. Miklaszewska
    • 3
  • J. Pietrzyk
    • 3
  • A. Rybi-Szumińska
    • 4
  • A. Wasilewska
    • 4
  • A. Firszt-Adamczyk
    • 5
  • R. Stankiewicz
    • 5
  • M. Szczepańska
    • 6
  • B. Bieniaś
    • 7
  • M. Zajączkowska
    • 7
  • A. Pukajło-Marczyk
    • 8
  • D. Zwolińska
    • 8
  • K. Siniewicz-Luzeńczyk
    • 9
  • M. Tkaczyk
    • 9
  • K. Gadomska-Prokop
    • 10
  • R. Grenda
    • 10
  • U. Demkow
    • 11
  • M. Pańczyk-Tomaszewska
    • 1
  1. 1.Department of Pediatrics and NephrologyMedical University of WarsawWarsawPoland
  2. 2.Department of PathologyMedical University of WarsawWarsawPoland
  3. 3.Department of Pediatric NephrologyJagiellonian UniversityCracowPoland
  4. 4.Department of Pediatrics and NephrologyMedical University of BialystokBialystokPoland
  5. 5.Department of Pediatrics and NephrologyLudwik Rydygier HospitalTorunPoland
  6. 6.Department of Pediatrics, SMDZ in ZabrzeSilesian Medical UniversityKatowicePoland
  7. 7.Department of Pediatric NephrologyMedical University of LublinLublinPoland
  8. 8.Department of Pediatric NephrologyWroclaw Medical UniversityWroclawPoland
  9. 9.Department of Pediatrics, Immunology and NephrologyPolish Mothers Memorial Hospital Research InstituteLodzPoland
  10. 10.Department of Nephrology, Kidney Transplantation and HypertensionChildren’s Memorial Health InstituteWarsawPoland
  11. 11.Department of Laboratory Diagnostics and Clinical Immunology of Developmental AgeMedical University of WarsawWarsawPoland

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