Open AccessArticle
Heterogeneous Renal Trajectories in Pediatric IgA Nephropathy: A Single-Center Experience Highlighting the Dynamic Nature of Early Disease
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John Dotis, Antonia Kondou, Vasiliki Karava, Maria Tsirevelou, Ioannis Koutras, Olympia Dadoudi, George Liapis, Despoina Tramma, Maria Stamou and Nikoleta Printza
Pediatr. Rep. 2026, 18(4), 84; https://doi.org/10.3390/pediatric18040084 (registering DOI) - 23 Jun 2026
Abstract
Background/Objectives: Pediatric IgA nephropathy (IgAN) is often considered to have a favorable early course. However, its progression is variable, and the prognostic value of histopathological classifications, such as MEST-C, remains incompletely defined in children. This study aimed to characterize clinicopathological features and the
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Background/Objectives: Pediatric IgA nephropathy (IgAN) is often considered to have a favorable early course. However, its progression is variable, and the prognostic value of histopathological classifications, such as MEST-C, remains incompletely defined in children. This study aimed to characterize clinicopathological features and the early disease course in pediatric IgAN and to descriptively examine histopathological findings and clinical outcomes. Methods: This retrospective, single-center study included children with biopsy-confirmed IgAN diagnosed between 2016 and 2025. Clinical, laboratory, and histopathological data were collected, and biopsies were assessed using the Oxford MEST-C classification. Follow-up data, including estimated glomerular filtration rate (eGFR), were analyzed descriptively, with follow-up extending from diagnosis to early 2026. Results: Fourteen patients were included, showing heterogeneous clinical presentations. Mesangial hypercellularity was observed in all cases (100%), with frequent endocapillary hypercellularity (78.6%) and segmental sclerosis (57.1%), consistent with a predominance of active lesions. Over a median follow-up of approximately five years, renal function remained stable in 57.1% of patients, declined in 21.4%, and improved in 14.3%, indicating variability in renal function during follow-up and potential reversibility in a subset of patients. One patient (7.1%) developed severe acute kidney injury requiring temporary dialysis, followed by full recovery. Given the descriptive design and limited sample size, no conclusions regarding associations between histopathological findings and renal outcomes can be drawn. Conclusions: Within this small cohort, pediatric IgAN showed variable renal function courses ranging from stability to decline or partial recovery. These findings should be considered descriptive and hypothesis-generating, supporting longitudinal monitoring in larger pediatric cohorts.
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