We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
IgA nephropathy in children with minimal proteinuria: to biopsy or not to biopsy?
- Authors
Cambier, Alexandra; Roy, Jean-Philippe; Dossier, Claire; Patey, Natacha; Rabant, Marion; Boyer, Olivia; Delbet, Jean Daniel; Lapeyraque, Anne-Laure; Hogan, Julien
- Abstract
Background: Tubulointerstitial lesions and glomerular inflammation severity have been shown to correlate with proteinuria in children with IgA nephropathy (cIgAN). However, there is a lack of data regarding severity of histopathologic findings in cIgAN in patients with minimal to absent proteinuria since kidney biopsy indications are not well defined in these cases. Methods: Twenty-eight cIgAN patients with kidney biopsy from 4 different centers in Paris (France) and Montreal (Canada) with a urine protein/creatinine ratio (UPCr) ≤ 0.03 g/mmol and a normal estimated glomerular filtration rate (eGFR > 90 ml/min/1.73 m2) on the day of kidney biopsy prior to treatment were included. Results: Median age was 11.82 (9.32–13.45) years, and median follow-up was 4 years (2.87–6.53). At time of biopsy, median eGFR was 116 (102.3–139.7) ml/min/1.73 m2, and median UPCr was 0.02 (0.011–0.03) g/mmol. Microscopic or macroscopic hematuria was present in 35.7% and 64.3% of cases, respectively. Kidney biopsy microscopy analysis showed mesangial (M1), endocapillary (E1), or extracapillary (C1) hypercellularity in 53.5%, 32.1%, and 7.1% of patients, respectively. Chronic histological lesions were also present: glomerulosclerosis (S1) in 42.8% and tubular atrophy/interstitial fibrosis in 7.1%. Podocytopathic features were detected in 21.4%. An ACE inhibitor or immunosuppressive therapy (IS) was prescribed in 42.8% and 21.4% of these patients respectively. One-third (35.7%) received no treatment. At last follow-up, median eGFR was 111.9 (90.47–136.1) ml/min/1.73 m2, and median UPCr was 0.028 (0.01–0.03) g/mmol. Conclusion: cIgAN with minimal proteinuria at time of biopsy might be linked with acute and chronic glomerular lesions.
- Subjects
FRANCE; CANADA; PROTEINURIA diagnosis; GLOMERULAR filtration rate; PROTEINS; BIOPSY; MICROSCOPY; DESCRIPTIVE statistics; GLOMERULONEPHRITIS; HEMATURIA; CREATININE; KIDNEY glomerulus
- Publication
Pediatric Nephrology, 2024, Vol 39, Issue 3, p781
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-023-06121-7