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Open AccessArticle

Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy

1
Departments of Pediatrics, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon 14647, Korea
2
Yeungnam University Hospital, Daegu 42415, Korea
3
St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Korea
4
Hallym University Sacred Heart Hospital, Anyang 14068, Korea
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Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul 05505, Korea
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Ajou University Hospital, School of Medicine, Suwon 16499, Korea
7
Department of Pediatrics, Yonsei University College of Medicine, Seoul 03722, Korea
8
Korea University Guro Hospital, Seoul 08308, Korea
9
Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Korea
10
Pusan National University Children’s Hospital, Yangsan 50612, Korea
11
National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
12
Jeonbuk National University Hospital, Jeonju 54907, Korea
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Ewha Womans University Seoul Hospital, Seoul 07804, Korea
14
School of Medicine, Kyungpook National University, Daegu 41944, Korea
15
Seoul National University Bundang Hospital, Seongnam 13620, Korea
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Inje University Sanggye Paik Hospital, Seoul 01757, Korea
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Jeju National University School of Medicine, Jeju 63243, Korea
18
Chonnam National University Hospital and Medical School, Hwasun 58128, Korea
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Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
20
Konkuk University Hospital, Seoul 05029, Korea
21
Seoul National University College of Medicine and Seoul National University Children’s Hospital, Seoul 03080, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2058; https://doi.org/10.3390/jcm9072058
Received: 9 June 2020 / Revised: 24 June 2020 / Accepted: 27 June 2020 / Published: 30 June 2020
Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulopathies diagnosed in children and adolescents. This study aimed to evaluate the clinical features in and outcomes of pediatric IgAN over the last 30 years. Patients who were diagnosed before age of 18 at 20 centers in Korea were evaluated retrospectively. Of the 1154 patients (768 males, 386 females) with a median follow-up of 5 years, 5.6% (n = 65) progressed to stage 3–5 chronic kidney disease (CKD). The 10- and 20-year CKD-free survival rates were 91.2% and 75.6%, respectively. Outcomes did not differ when comparing those in Korea who were diagnosed prior to versus after the year 2000. On multivariate analysis, combined asymptomatic hematuria and proteinuria as presenting symptoms and decreased renal function at the time of biopsy were associated with progression to CKD, while remission of proteinuria was negatively associated with this outcome. Patients who presented with gross hematuria or nephrotic syndrome tended toward positive outcomes, especially if they ultimately achieved remission. While remission of proteinuria might imply that the disease is inherently less aggressive, it also can be achieved by management. Therefore, more aggressive management might be required for pediatric-onset IgAN. View Full-Text
Keywords: children; IgA nephropathy; long-term outcome; remission of proteinuria children; IgA nephropathy; long-term outcome; remission of proteinuria
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Suh, J.-S.; Jang, K.M.; Hyun, H.; Cho, M.H.; Lee, J.H.; Park, Y.S.; Oh, J.H.; Kim, J.H.; Yoo, K.H.; Chung, W.Y.; Kim, S.H.; Kim, K.; Lee, D.Y.; Lee, J.W.; Cho, M.H.; Park, H.; Koo, J.W.; Han, K.H.; Yang, E.M.; Lee, K.H.; Shin, J.I.; Cho, H.; Kim, K.S.; Ha, I.-S.; Park, Y.H.; Kang, H.G. Remission of Proteinuria May Protect against Progression to Chronic Kidney Disease in Pediatric-Onset IgA Nephropathy. J. Clin. Med. 2020, 9, 2058.

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