Pronóstico en la vida adulta de la nefropatía igA diagnosticada en la edad pediátrica
2001; Elsevier BV; Volume: 116; Issue: 10 Linguagem: Inglês
10.1016/s0025-7753(01)71831-3
ISSN1578-8989
AutoresGema Ariceta, Yolanda M. López‐Fernández, Alfredo Vallo, Juan Rodríguez Soriano, Nieves Gallegoa, M. Jesús Quintela,
Tópico(s)Chronic Kidney Disease and Diabetes
ResumoTo evaluate long-term prognosis in a group of children with IgA nephropathy and to analyse which clinical factors were associated with progression to chronic renal failure in adulthood.Retrospective study. 58 young adults with IgA nephropathy diagnosed at 10.6(SD 2.9) years old and studied after a follow-up of 11.8 (SD 2.9) years.Relapses of macroscopic hematuria and proteinuria were the most frequent symptoms at onset (75.9%). In 25.9% of patients high plasmatic IgA levels were also detected. Most cases had grade I (44.8%)or grade II (44.8%) histological lesions at diagnosis. At the last control, clinical remision was observed in 21 patients (36.2%) and 50% of the whole group remained with abnormal urine. 8 patients(13.8%) reached terminal renal failure. Mean renal survival (defined as glomerular filtration rate above 50 ml/min/1.73 m2)was 100, 93.3 and 81.1% at 5, 10 and 15 years of evolution, respectively.About 14% of children with IgA nephropathy had long-term renal bad prognosis. Hypertension at onset, plasma creatinine elevation and proteinuria during adolescence were significant risk factors associated with chronic renal failure during adulthood. Minimal lesions at IgA nephropathy diagnosis in children did not exclude long-term poor prognosis.
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