Clinicopathologic characteristics and prognosis of primary IgA nephropathy in children

Objectives To explore the clinical manifestations,pathological features,and prognosis of primary IgA nephropathy(IgAN)in children. Methods The clinical manifestations and pathological features were analyzed in 81 children with IgAN. Effect of treatment was assessed in individual cases through 0.5 ～ 84 month follow-up. Results Simple hematuria and hematuria combined with proteinuria were the most common clinical manifestation (33.3%),followed by nephrotic syndrome(21.0%)and chronic nephritic syndrome(4.9%). Pathological analysis showed that Grade III nephropathy was the most common(53.1%),followed by Grade II (30.9%)and Grade IV(12.3%). The deposition of solo IgA in the glomeruli was the most common(75.3%),followed by IgA + IgM + IgG(+C3)deposition(17.3%) and IgA+IgM(+C3)deposition (7.4%). The severity of glomerular lesion was significantly correlated with clinical manifestations(χ2 = 6.769,P = 0.034). During the follow-up(mean duration of 27 months),66 out of 73 children (90.4%)had normal renal function and decreased excretion of protein in urine( 1 g/24 h=. Conclusions The clinical manifestations of primary IgAN in children are correlated with pathological changes. The patients with nephrotic syndrome or nephritic syndrome are more likely to have severe pathological changes. Renal functions will be improved when the the symptoms are relieved by early treatment.