Differences in response to treatment in children with severe IgA nephropathy according to patient age.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL Fukushima Journal of Medical Science Pub Date : 2023-08-10 DOI:10.5387/fms.2022-42
Yukihiko Kawasaki, Yohei Kume, Atsushi Ono, Ryo Maeda, Hayato Go
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Abstract

Aim: To clarify whether the response to treatment of IgA nephropathy (IgAN) differs depending on patient age, we examined the response to treatment according to age of onset in children with IgAN.

Methods: We collected data for 44 children with severe IgAN. The children were retrospectively divided into three groups based on their age at disease onset. Group 1 consisted of 24 children under 11 years old, group 2 consisted of 9 children aged 12 to 13 years, and group 3 consisted of 11 children aged over 14 years old. The clinical features and prognosis were analyzed for each group.

Results: The urinary protein excretion and serum IgA values in group 3 were higher than those in groups 1 and 2 at the most recent follow up, and histological findings showed that the MESTCG scores in group 3 were higher than those in group 1. Furthermore, the incidence of patients with persistent nephropathy or renal insufficiency in group 3 was higher than those in groups 1 and 2.

Conclusions: Patients aged 14 years and older with IgAN may respond poorly to treatment compared with those younger than 14 years old. Therefore, care must be taken regarding response to treatment and relapse when treating older children.

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严重IgA肾病患儿治疗反应的年龄差异
目的:为了阐明对IgA肾病(IgAN)治疗的反应是否因患者年龄而异,我们根据IgAN患儿的发病年龄检查了对治疗的反应。方法:收集44例重症IgAN患儿资料。这些儿童根据发病年龄被回顾性地分为三组。第一组为24名11岁以下儿童,第二组为9名12 - 13岁儿童,第三组为11名14岁以上儿童。分析各组患者的临床特点及预后。结果:3组最近随访时尿蛋白排泄量及血清IgA值均高于1、2组,组织学检查显示3组MESTCG评分高于1组。3组患者出现持续性肾病或肾功能不全的发生率高于1组和2组。结论:与14岁以下的IgAN患者相比,14岁及以上的IgAN患者对治疗的反应可能较差。因此,在治疗大龄儿童时,必须注意对治疗的反应和复发。
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来源期刊
Fukushima Journal of Medical Science
Fukushima Journal of Medical Science MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
12.50%
发文量
24
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