Clinicopathological features and prognosis of IgA vasculitis nephritis with nephrotic-range proteinuria in children.

Background: To investigate the clinical features, kidney pathology, treatment regimens, and clinical outcomes of IgA vasculitis nephritis (IgAVN) with nephrotic-range proteinuria in children. Methods: A retrospective review of children diagnosed with IgAVN between January 2019 and December 2022 was...

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Publicado en:Pediatric Nephrology Vol. 39; no. 11; pp. 3241 - 3251
Autores principales: Xi, Leying, Sun, Yuying, Chen, Yawei, Yang, Xiaoqing, Su, Hang, Ren, Xianqing
Formato: research tables/charts Journal Article
Publicado: Springer Nature Nov2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2024
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        10.1007/s00467-024-06441-2
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        atl: Clinicopathological features and prognosis of IgA vasculitis nephritis with nephrotic-range proteinuria in children.
      aug:
        au:
          Xi, Leying
          Sun, Yuying
          Chen, Yawei
          Yang, Xiaoqing
          Su, Hang
          Ren, Xianqing
        affil: https://ror.org/0536rsk67 Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
      sug:
        subj:
          Disease Attributes
          Nephritis Prognosis
          Nephritis Physiopathology
          Proteinuria
          Purpura, Schoenlein-Henoch Prognosis
          Purpura, Schoenlein-Henoch Physiopathology
          Purpura, Schoenlein-Henoch Therapy
          Human
          Funding Source
          Child
          Treatment Outcomes
          Retrospective Design
          Proteins Urine
          Creatinine Urine
          Record Review
          Age Factors
          Immunoglobulins
          Kidney Failure, Acute Pathology
          Blood Urea Nitrogen
          Fibrin Fibrinogen Degradation Products
          Albumins
          Prothrombin Time
          Partial Thromboplastin Time
          Comparative Studies
          Child: 6-12 years
      ab: Background: To investigate the clinical features, kidney pathology, treatment regimens, and clinical outcomes of IgA vasculitis nephritis (IgAVN) with nephrotic-range proteinuria in children. Methods: A retrospective review of children diagnosed with IgAVN between January 2019 and December 2022 was conducted. Participants were divided into two groups based on their urine protein/creatinine (UPCR) levels. Biodata, clinical characteristics, laboratory findings, pathologic features, treatment regimens, and outcomes were abstracted from case records and analyzed. Results: A total of 255 children were identified, 94 with nephrotic-range proteinuria (UPCR ≥ 200 mg/mmol) and 161 with non-nephrotic proteinuria (UPCR < 200 mg/mmol). Patients in the nephrotic-range proteinuria group were significantly younger and had worse grades of glomerular and acute tubulointerstitial injury compared to those in the non-nephrotic proteinuria group. Higher levels of blood urea nitrogen (BUN), D-dimer (DD), and fibrin degradation products (FDP), and lower levels of total protein (TP), albumin (ALB), urine creatinine (Cr), prothrombin time (PT), activated partial thromboplastin time (APTT), IgG, CD3 + cells, and CD4 + cells were found in patients in the nephrotic-range proteinuria group. Clinical outcome of patients with nephrotic-range proteinuria was significantly associated with ISKDC grading, proportion of glomerular crescents and severity of acute tubulointerstitial injury. Conclusions: Children with nephrotic-range proteinuria exhibit more severe disordered immunologic function, hypercoagulability, glomerular and tubulointerstitial pathological damage, and have worse outcomes than those with lower proteinuria levels. Clinicians should pay great attention to the kidney injury and more extensive studies are required to identify optimal treatment regimens to improve outcomes in patients.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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