[Multicenter investigation of therapeutic status of children with IgA nephropathy in China].

OBJECTIVE

Data of general status of clinical presentation and therapy of IgA nephropathy in children in China are lacking. This study aimed to investigate the clinical presentations and treatment status of children with IgA nephropathy in China.

METHOD: The investigation was organized by Chinese Society of Pediatric Nephrology. Thirty five centers from 23 provinces/municipalities of China participated in the study. Children no more than 18 years old who were diagnosed by renal biopsy as IgA nephropathy from July 1, 2008 to June 20, 2011 were included. The data on clinical presentations and treatment methods were collected. Descriptive method was used for data analysis.

RESULT: Totally 1417 children aged from 0.5 to 18 years old were included. The median age was 10.0 years old. Children more than 6 years old accounted for 89.8%. Most of the children presented with hematuria and proteinuria (37.0%), nephrotic syndrome type accounted for 30.6%, isolated hematuria type accounted for 15.8%, acute glomerulonephritis type accounteed for 12.7%, chronic glomerulonephritis type accounted for 1.8%, acute rapidly progressive glomerulonephritis type accounted for 1.3%, isolated proteinuria type accounted for 0.8%. The common drug used for children with hematuria and proteinuria type included angiotensin-converting enzyme inhibitor(ACEI)/angiotensin II receptor antagonists (ARB) (49.6%), oral prednisone (41.4%), intravenous methylprednisolone (20.8%), etc. The therapies with oral prednisone (76.2%), ACEI/ARB (60.5%), cyclophosphamide (40.0%), intravenous methylprednisolone (31.2%) were more often used for children with nephrotic syndrome type.

CONCLUSION

This is the first nationwide investigation on therapy status of children with IgA nephropathy in China. Steroid combined with ACEI/ARB and cyclophosphamide was the main treatment for children with nephrotic syndrome type. The effect of steroid combined with immunosuppressant on other types of IgA nephropathy needs further investigation.