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Článek

PubMed

Záznam pochází z PubMed

Risk factors for progression in children and young adults with IgA nephropathy: an analysis of 261 cases from the VALIGA European cohort

Pediatric nephrology (Berlin, Germany). 2017 Jan ; 32 (1) : 139-150. [epub] 20160825

Pediatr Nephrol
ISSN 1432-198X | 0931-041X
Zdroj

Jazyk angličtina Země Německo Médium print-electronic

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz https://www.medvik.cz/link/pmid27557557

PubMed 27557557
DOI 10.1007/s00467-016-3469-3
PII: 10.1007/s00467-016-3469-3
Knihovny.cz E-zdroje

Klíčová slova
IgA nephropathy, Pathology classification, Progression, Proteinuria, Risk factors,
MeSH
analýza přežití MeSH
biopsie MeSH
chronické selhání ledvin epidemiologie patologie MeSH
dítě MeSH
hodnoty glomerulární filtrace MeSH
hormony kůry nadledvin terapeutické užití MeSH
IgA nefropatie farmakoterapie epidemiologie patologie MeSH
imunosupresiva MeSH
kohortové studie MeSH
kojenec MeSH
ledviny patologie MeSH
lidé MeSH
předškolní dítě MeSH
progrese nemoci MeSH
proteinurie epidemiologie patologie MeSH
retrospektivní studie MeSH
rizikové faktory MeSH
sexuální faktory MeSH
stanovení cílového parametru MeSH
věkové faktory MeSH
Check Tag
dítě MeSH
kojenec MeSH
lidé MeSH
mužské pohlaví MeSH
předškolní dítě MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH
Geografické názvy
Evropa epidemiologie MeSH
Názvy látek
hormony kůry nadledvin MeSH
imunosupresiva MeSH

BACKGROUND: There is a need for early identification of children with immunoglobulin A nephropathy (IgAN) at risk of progression of kidney disease. METHODS: Data on 261 young patients [age <23 years; mean follow-up of 4.9 (range 2.5-8.1) years] enrolled in VALIGA, a study designed to validate the Oxford Classification of IgAN, were assessed. Renal biopsies were scored for the presence of mesangial hypercellularity (M1), endocapillary hypercellularity (E1), segmental glomerulosclerosis (S1), tubular atrophy/interstitial fibrosis (T1-2) (MEST score) and crescents (C1). Progression was assessed as end stage renal disease and/or a 50 % loss of estimated glomerular filtration rate (eGFR) (combined endpoint) as well as the rate of renal function decline (slope of eGFR). Cox regression and tree classification binary models were used and compared. RESULTS: In this cohort of 261 subjects aged <23 years, Cox analysis validated the MEST M, S and T scores for predicting survival to the combined endpoint but failed to prove that these scores had predictive value in the sub-group of 174 children aged <18 years. The regression tree classification indicated that patients with M1 were at risk of developing higher time-averaged proteinuria (p < 0.0001) and the combined endpoint (p < 0.001). An initial proteinuria of ≥0.4 g/day/1.73 m2 and an eGFR of <90 ml/min/1.73 m2 were determined to be risk factors in subjects with M0. Children aged <16 years with M0 and well-preserved eGFR (>90 ml/min/1.73 m2) at presentation had a significantly high probability of proteinuria remission during follow-up and a higher remission rate following treatment with corticosteroid and/or immunosuppressive therapy. CONCLUSION: This new statistical approach has identified clinical and histological risk factors associated with outcome in children and young adults with IgAN.

Annunziata Hospital Cosenza Italy

Bambino Gesù Hospital Rome Italy

Belcolle Hospital Viterbo Italy

Borgomanero Hospital Borgomanero Italy

Fondazione Ricerca Molinette Nephrology Dialysis and Transplantation Regina Margherita Hospital Turin Italy

General University Hospital Prague Czech Republic

Hacettepe University Ankara Turkey

Hospital 12 de Octubre Madrid Spain

Hospital Maggiore di Lodi Lodi Italy

Imperial College Hammersmith Hospital London UK

Karolinska Institutet Stockholm Sweden

Karolinska University Hospital Huddinge Sweden