Journal of nephrology · 2026
Clinicopathological features and risk factor analysis of pediatric IgA vasculitis with nephritis associated with acute kidney injury.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Kuang Qian-Huining, Yang Meng, Xia Wei, Yan Shi-Jun, Xu Chao, Hu Jian, Lin Tong-Tong, Yao Jun, Yang Xiao, Zhang Pei, Gao Chun-Lin, Xia Zheng-Kun
Аннотация
BACKGROUND: Immunoglobulin A vasculitis with nephritis (IgAVN) is the most common form of secondary glomerulonephritis in children. Some individuals have acute kidney disease (AKD) early on in their illness. The purpose of this study was to examine the prognosis and clinicopathological characteristics of children with IgAVN complicated by AKD.
METHODS: Five medical centers in China provided data on pediatric patients with biopsy-proven IgAVN. The patients were divided into two groups: AKD group and non-AKD group, depending on whether AKD was present at disease onset. Clinical manifestations, laboratory findings, pathological characteristics, and prognostic outcomes were compared between the two groups.
RESULTS: Among 1862 children with IgAVN, 213 (11.44%) presented with AKD. Compared to children in the non-AKD group, children in the AKD group had more severe clinical and pathological findings. Kaplan-Meier analysis revealed statistically significant differences in kidney survival among the three stages of AKD (χ² = 15.68, P < 0.0001), and showed that kidney survival in the AKD group was significantly lower than that in the non-AKD group (χ² = 14.75, P < 0.0001) over a median follow-up of 66 months. AKD was identified as an independent risk factor for progression to chronic kidney disease stage 5 (CKD 5) in both short-term (6 months) and long-term (five- and ten-year) follow-ups.
CONCLUSIONS: The clinicopathological and pathological features are much more severe in IgAVN children with AKD. AKD is a significant risk factor for unfavorable short- and long-term outcomes in pediatric IgAVN.
METHODS: Five medical centers in China provided data on pediatric patients with biopsy-proven IgAVN. The patients were divided into two groups: AKD group and non-AKD group, depending on whether AKD was present at disease onset. Clinical manifestations, laboratory findings, pathological characteristics, and prognostic outcomes were compared between the two groups.
RESULTS: Among 1862 children with IgAVN, 213 (11.44%) presented with AKD. Compared to children in the non-AKD group, children in the AKD group had more severe clinical and pathological findings. Kaplan-Meier analysis revealed statistically significant differences in kidney survival among the three stages of AKD (χ² = 15.68, P < 0.0001), and showed that kidney survival in the AKD group was significantly lower than that in the non-AKD group (χ² = 14.75, P < 0.0001) over a median follow-up of 66 months. AKD was identified as an independent risk factor for progression to chronic kidney disease stage 5 (CKD 5) in both short-term (6 months) and long-term (five- and ten-year) follow-ups.
CONCLUSIONS: The clinicopathological and pathological features are much more severe in IgAVN children with AKD. AKD is a significant risk factor for unfavorable short- and long-term outcomes in pediatric IgAVN.