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Journal of the Korean Society of Pediatric Nephrology 2013;17(2): 49-56. doi: https://doi.org/10.3339/jkspn.2013.17.2.49
학교 집단 요검사로 조기 진단된 IgA 신증 환아의 임상적 특징
김세윤, 이상수, 이재민, 강석정, 김용진*, 박용훈
1영남대학교 의과대학 소아청소년과, 병리학교실*
2순천향대학교 의과대학 구미병원 소아청소년과†
The Characteristics of IgA Nephropathy when Detected early in Mass School Urine Screening
Sae Yoon Kim, Sang Su Lee, Jae Min Lee, Seok Jeong Kang, Yong Jin Kim*, Yong Hoon Park
1Department of Pediatrics and Pathology* College of Medicine, Yeungnam University, Daegu, Korea
2Department of Pediatrics†, Soonchunhyang University, Gumi Hospital, Gumi, Korea
Corresponding Author: Yong Hoon Park ,Tel: 053-620-3532, Fax: 053-629-2292, Email: yhpark@ynu.ac.kr
Received: September 17, 2012;  Accepted: August 23, 2013.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Purpose: IgA nephropathy (IgAN) is one of the major causes of end-stage renal disease. Mass school urine screening (SUS) has been performed to enable early detection of chronic renal diseases, including IgAN. We wanted to evaluate the patients with IgAN, including those diagnosed through SUS.

Between 1998 and 2010, 64 children were diagnosed with IgAN based on renal biopsy results obtained at the Pediatric Nephrology Department, OO University Hospital. We divided these patients into the SUS group (37 cases), diagnosed through SUS, and the symptomatic (Sx) group (27 cases), diagnosed clinically. The medical records of both groups were analyzed retrospectively.

Results :
The mean age of the SUS and Sx groups was 10.8±2.7 and 9.5±3.4 years (P >0.05), respectively. Both groups had a higher proportion of male patients. The time from the notification of an abnormal urinary finding to a hospital visit or renal biopsy was shorter in the Sx group than in the SUS group. Regarding clinical manifestations, there were fewer cases with gross hematuria (P <0.001) and edema (P =0.008) in the SUS group, but there were no differences in terms of the therapeutic regimen and treatment duration. Regarding laboratory parameters, the Sx group had a higher white blood cell count (P =0.007) and lower hemoglobin (P =0.007) and albumin (P =0.000) levels. There were no differences in the renal biopsy findings in both groups, based on the history of gross hematuria or the severity of proteinuria. However, in all 64 patients with IgAN, the light microscopy findings (Hass classification) were related to a history of gross hematuria or the severity of proteinuria.

Conclusion :
There were no significant clinical and histological differences between the groups, as both had early stage IgAN. Although SUS facilitates the early detection of IgAN, long-term, large-scale prospective controlled studies are needed to assess the benefits of early diagnosis and treatment in chronic renal disease progression.
Key words: Early detection | Renal biopsy | End-stage renal disease
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