Clinical Course of IgA Nephropathy in Children

Hong, In-Hee; Lee, Jun-Hwa; Go, Cheol-Woo; Kwak, Jung-Sik; Koo, Ja-Hoon

J Korean Soc Pediatr Nephrol > Volume 3(2); 1999 > Article

J Korean Soc Pediatr Nephrol 1999;3(2): 153-160.

소아 IgA 신병증의 추적 관찰

홍인희, 이준화, 고철우, 곽정식, 구자훈

¹경북대학교 의과대학 소아과학교실
²경북대학교 의과대학 소아과학교실
³경북대학교 의과대학 소아과학교실
⁴경북대학교 의과대학 병리학교실
⁵경북대학교 의과대학 소아과학교실

Clinical Course of IgA Nephropathy in Children

In-Hee Hong, Jun-Hwa Lee, Cheol-Woo Go, Jung-Sik Kwak, Ja-Hoon Koo

¹Department of Pediatrics, Kyungpook National University School of Medicine
²Department of Pediatrics, Kyungpook National University School of Medicine
³Department of Pediatrics, Kyungpook National University School of Medicine
⁴Department of Pathology, Kyungpook National University School of Medicine
⁵Department of Pediatrics, Kyungpook National University School of Medicine

ABSTRACT

Purpose : Present study was undertaken to find out significance of clinical presentation, initial laboratory data and renal biopsy findings on subsequent clinical course of IgA nephropathy in children.
Methods : Clinical and laboratory data were analysed retrospectively from 60 children who have been admitted to the Pediatric Department of Kyungpook National University Hospital for the past 11 years and diagnosed as IgA nephropathy. Renal biopsy findings were graded according to the pathologic subclass proposed by Haas.
Results : Pathologic grading according to Haas subclassification showed 10 cases in subclass I, 36 in II, 12 in IV and 2 in V and none in subclass II. Sex distribution showed male predominance (male to female ratio = 3 : 1) and mean age at onset of disease was $10.4{pm}2.8$ years. Episodes of gross hematuria was seen in 71.7% and IgA level increased in 28.3% of children and these were not associated with pathologic grading nor clinical outcomes. With increasing subclass grading, serum protein and albumin decreased and 24 hours urinary protein excretion increased. Normalization of urinalysis (disappearance of hematuria) was seen in 14% at 1-2 years and 37.1% at 3-4 years of follow up period. In 3 cases, renal function deteriorated progressively and they belonged one each to the Haas subclass III, IV and V.
Conclusion : In children with IgA nephropathy, progression to chronic renal failure appears to be quite high and pathologic grading according to Haas' subclassification seems to predict patient's outcome faily well. However, firm conclusion cannot be drawn from present study due to the small numbers of patients and short follow-up period. Therefore further multicenter study involving larger numbers of patients and longer periods of follow-up over 10 years was to be undertaken.

Key words: IgA nephropathy | Recurrent gross hematuria | Chronic renal failure