Are children with IgA nephropathy different from adult patients?
© 2024. The Author(s)..
BACKGROUND: Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN.
METHODS: We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN.
RESULTS: A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m2, p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids.
CONCLUSIONS: Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Pediatric nephrology (Berlin, Germany) - (2024) vom: 05. Apr. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Su, Baige [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adults |
|---|
| Anmerkungen: |
Date Revised 05.04.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1007/s00467-024-06361-1 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370678850 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370678850 | ||
| 003 | DE-627 | ||
| 005 | 20240405234916.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240405s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00467-024-06361-1 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1366.xml |
| 035 | |a (DE-627)NLM370678850 | ||
| 035 | |a (NLM)38578470 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Su, Baige |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Are children with IgA nephropathy different from adult patients? |
| 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 Revised 05.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN | ||
| 520 | |a METHODS: We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN | ||
| 520 | |a RESULTS: A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m2, p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids | ||
| 520 | |a CONCLUSIONS: Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adults | |
| 650 | 4 | |a Children | |
| 650 | 4 | |a IgA nephropathy | |
| 650 | 4 | |a Remission of proteinuria | |
| 650 | 4 | |a Steroid | |
| 700 | 1 | |a Jiang, Yuanyuan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Zhihui |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Jianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Rong, Liping |e verfasserin |4 aut | |
| 700 | 1 | |a Feng, Shipin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhong, Fazhan |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Shuzhen |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Dongfeng |e verfasserin |4 aut | |
| 700 | 1 | |a Xia, Zhengkun |e verfasserin |4 aut | |
| 700 | 1 | |a Feng, Chunyue |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Wenyan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Xiaoyan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Chaoying |e verfasserin |4 aut | |
| 700 | 1 | |a Hao, Zhihong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Mo |e verfasserin |4 aut | |
| 700 | 1 | |a Qin, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Minguang |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yuanyuan |e verfasserin |4 aut | |
| 700 | 1 | |a Ding, Juanjuan |e verfasserin |4 aut | |
| 700 | 1 | |a Bao, Ying |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Xiaorong |e verfasserin |4 aut | |
| 700 | 1 | |a Deng, Fang |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Xueqin |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xuan |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Huandan |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Xiaojie |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Qianliang |e verfasserin |4 aut | |
| 700 | 1 | |a Deng, Linxia |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Xiaoyun |e verfasserin |4 aut | |
| 700 | 1 | |a Xie, Min |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Lichun |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Ling |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Chunlin |e verfasserin |4 aut | |
| 700 | 1 | |a Mao, Jianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Weihua |e verfasserin |4 aut | |
| 700 | 1 | |a Dang, Xiqiang |e verfasserin |4 aut | |
| 700 | 1 | |a Xia, Hua |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yujie |e verfasserin |4 aut | |
| 700 | 1 | |a Zhong, Xuhui |e verfasserin |4 aut | |
| 700 | 1 | |a Ding, Jie |e verfasserin |4 aut | |
| 700 | 1 | |a Lv, Jicheng |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Hong |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pediatric nephrology (Berlin, Germany) |d 1995 |g (2024) vom: 05. Apr. |w (DE-627)NLM012612111 |x 1432-198X |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:05 |g month:04 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00467-024-06361-1 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 05 |c 04 | ||