Relationship between Renal Tubulointerstitial Lesion and Progression of Immunoglobulin A Nephropathy in Children

Objective To observe the characteristics of the clinical and pathological characteristics of immunoglobulin A nephropathy(IgAN),and to analyze the relationship between renal tubulointerstitial lesions(TIL)and progression of IgAN in children.Methods One hundred and sixty-five patients with primary IgAN(107 cases were male,58 cases were female;their ages were 3-17 years old)were diagnosed as primary IgAN combined with clinic and renal biopsy from Jan.2004 to Dec.2008.The clinical pathological features of the children with IgAN were analyzed retrospectively,and the relationships between them were investigated.Results In histological examination,all patients presented mesangial lesions,with or without segmental peripheral loops lesions.The acute severe lesions showed fibrinoid necrosis,crescents,and the chronic lesions were peripheral loops scar and globe sclerosis.Among all the patients,those without TIL accounted for 15.2 %,those with mild TIL was 43.6%,moderate TIL was 33.9%,while severe TIL was about 7.3%.The servrity of TIL was associated with the clinical glomerular pathological features:there was no significant difference in the age and the course of disease for different TIL groups(P0.05).With the increase of the severity of TIL,hypertension,proteinuria became worse and serum creatinine increased;With the increase of the score of mesangial lesions and crescents,TIL became severe.TIL was closely correlated to the score of glomerulosclerosis(r=0.461,P0.01).Conclusions With the increase of the severity of TIL,the condition of IgAN becomes worse.TIL is closely related to the severity of glomeruler and vascular lesions,and these lesions may further lead to the development of TIL.TIL may be one of the key factors for the prognosis of IgAN.