IgA nephropathy in children with minimal proteinuria : to biopsy or not to biopsy?
© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association..
BACKGROUND: Tubulointerstitial lesions and glomerular inflammation severity have been shown to correlate with proteinuria in children with IgA nephropathy (cIgAN). However, there is a lack of data regarding severity of histopathologic findings in cIgAN in patients with minimal to absent proteinuria since kidney biopsy indications are not well defined in these cases.
METHODS: Twenty-eight cIgAN patients with kidney biopsy from 4 different centers in Paris (France) and Montreal (Canada) with a urine protein/creatinine ratio (UPCr) ≤ 0.03 g/mmol and a normal estimated glomerular filtration rate (eGFR > 90 ml/min/1.73 m2) on the day of kidney biopsy prior to treatment were included.
RESULTS: Median age was 11.82 (9.32-13.45) years, and median follow-up was 4 years (2.87-6.53). At time of biopsy, median eGFR was 116 (102.3-139.7) ml/min/1.73 m2, and median UPCr was 0.02 (0.011-0.03) g/mmol. Microscopic or macroscopic hematuria was present in 35.7% and 64.3% of cases, respectively. Kidney biopsy microscopy analysis showed mesangial (M1), endocapillary (E1), or extracapillary (C1) hypercellularity in 53.5%, 32.1%, and 7.1% of patients, respectively. Chronic histological lesions were also present: glomerulosclerosis (S1) in 42.8% and tubular atrophy/interstitial fibrosis in 7.1%. Podocytopathic features were detected in 21.4%. An ACE inhibitor or immunosuppressive therapy (IS) was prescribed in 42.8% and 21.4% of these patients respectively. One-third (35.7%) received no treatment. At last follow-up, median eGFR was 111.9 (90.47-136.1) ml/min/1.73 m2, and median UPCr was 0.028 (0.01-0.03) g/mmol.
CONCLUSION: cIgAN with minimal proteinuria at time of biopsy might be linked with acute and chronic glomerular lesions.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
|---|---|
| Enthalten in: |
Pediatric nephrology (Berlin, Germany) - 39(2024), 3 vom: 01. März, Seite 781-787 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cambier, Alexandra [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Children |
|---|
| Anmerkungen: |
Date Completed 06.02.2024 Date Revised 10.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00467-023-06121-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361960417 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361960417 | ||
| 003 | DE-627 | ||
| 005 | 20240411232113.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00467-023-06121-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1372.xml |
| 035 | |a (DE-627)NLM361960417 | ||
| 035 | |a (NLM)37698655 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Cambier, Alexandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a IgA nephropathy in children with minimal proteinuria |b to biopsy or not to biopsy? |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 06.02.2024 | ||
| 500 | |a Date Revised 10.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association. | ||
| 520 | |a BACKGROUND: Tubulointerstitial lesions and glomerular inflammation severity have been shown to correlate with proteinuria in children with IgA nephropathy (cIgAN). However, there is a lack of data regarding severity of histopathologic findings in cIgAN in patients with minimal to absent proteinuria since kidney biopsy indications are not well defined in these cases | ||
| 520 | |a METHODS: Twenty-eight cIgAN patients with kidney biopsy from 4 different centers in Paris (France) and Montreal (Canada) with a urine protein/creatinine ratio (UPCr) ≤ 0.03 g/mmol and a normal estimated glomerular filtration rate (eGFR > 90 ml/min/1.73 m2) on the day of kidney biopsy prior to treatment were included | ||
| 520 | |a RESULTS: Median age was 11.82 (9.32-13.45) years, and median follow-up was 4 years (2.87-6.53). At time of biopsy, median eGFR was 116 (102.3-139.7) ml/min/1.73 m2, and median UPCr was 0.02 (0.011-0.03) g/mmol. Microscopic or macroscopic hematuria was present in 35.7% and 64.3% of cases, respectively. Kidney biopsy microscopy analysis showed mesangial (M1), endocapillary (E1), or extracapillary (C1) hypercellularity in 53.5%, 32.1%, and 7.1% of patients, respectively. Chronic histological lesions were also present: glomerulosclerosis (S1) in 42.8% and tubular atrophy/interstitial fibrosis in 7.1%. Podocytopathic features were detected in 21.4%. An ACE inhibitor or immunosuppressive therapy (IS) was prescribed in 42.8% and 21.4% of these patients respectively. One-third (35.7%) received no treatment. At last follow-up, median eGFR was 111.9 (90.47-136.1) ml/min/1.73 m2, and median UPCr was 0.028 (0.01-0.03) g/mmol | ||
| 520 | |a CONCLUSION: cIgAN with minimal proteinuria at time of biopsy might be linked with acute and chronic glomerular lesions | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Children | |
| 650 | 4 | |a IgA nephropathy | |
| 650 | 4 | |a Kidney biopsy | |
| 650 | 4 | |a Proteinuria | |
| 700 | 1 | |a Roy, Jean-Philippe |e verfasserin |4 aut | |
| 700 | 1 | |a Dossier, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Patey, Natacha |e verfasserin |4 aut | |
| 700 | 1 | |a Rabant, Marion |e verfasserin |4 aut | |
| 700 | 1 | |a Boyer, Olivia |e verfasserin |4 aut | |
| 700 | 1 | |a Delbet, Jean Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Lapeyraque, Anne-Laure |e verfasserin |4 aut | |
| 700 | 1 | |a Hogan, Julien |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pediatric nephrology (Berlin, Germany) |d 1995 |g 39(2024), 3 vom: 01. März, Seite 781-787 |w (DE-627)NLM012612111 |x 1432-198X |7 nnns |
| 773 | 1 | 8 | |g volume:39 |g year:2024 |g number:3 |g day:01 |g month:03 |g pages:781-787 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00467-023-06121-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 39 |j 2024 |e 3 |b 01 |c 03 |h 781-787 | ||