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Prognostic indicators in children with IgA nephropathy — Report of the Southwest Pediatric Nephrology Study Group

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Abstract

Investigators in 13 pediatric nephrology centers reviewed clinical and pathological features in 218 children and adolescents with IgA nephropathy (IgAN), with particular emphasis on 80 patients who had follow-up periods of at least 4 years. Potential prognostic markers in the 80 children were compared between 12 (15%) who developed end-stage renal disease (ESRD) versus 68 who did not. The relationship between clinical and pathological features and the subsequent development of ESRD was examined using stepwise linear discriminant analysis in addition to standard univariate analysis. Seven variables were found to be predictive of ESRD: the presence of glomerular sclerotic changes, especially when this was associated with proliferation or sclerosis in 20% or more of the glomeruli, black race; hypertension at biopsy; proteinuria at biopsy; age at presentation; crescents; male sex. Using the resulting discriminant function, development of ESRD could be correctly predicted in 95% of the subjects. We conclude that ESRD is more common in American children with IgAN than was realized previously. Risk factors previously documented in adult studies have been confirmed, especially the presence of glomerular sclerosis, proteinuria, and hypertension.

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Author information

Correspondence to Ronald J. Hogg.

Additional information

Southwest Pediatric Nephrology Study Group (Central Office, Baylor University Medical Center at Dallas, Tex., USA). Director, Ronald J. Hogg; statistician, Joan S. Reisch; administrative assistant, Kaye Green. Centers and Physicians participating in this study: Baylor College of Medicine, Houston, Tex., Phillip L. Berry, L. Leighton Hill, Sami A. Sanjad, Edith Hawkins; Baylor University Medical Center, Dallas, Tex., Ronald J. Hogg, Daniel Savino, Kaye Green; Tulane University Medical Center, New Orleans, La., Frank Boineau, John E. Lewy, Radhakrishna Baliga, Patrick Walker; University of Arkansas, Little Rock, Ark, Watson Arnold, Eileen Ellis, Edward Uthman; University of Colorado Health Science Center, Denver, Colo., Gary M. Lum, William Hammond; University of Oklahoma Medical Center, Oklahoma City, Okla., James Wenzl, James Matson, Geoffrey Altshuler, Sarah Johnson; University of Tennessee, Memphis, Tenn., F. Bruder Stapleton, Shane Roy III, Robert J. Wyatt, Charles McKay, William Murphy; University of Texas Southwestern Medical Center at Dallas, Tex., Billy S. Arant Jr, Michel Baum, Fred G. Silva, Arthur Weinberg, Craig Argyle, Joseph Rutledge, Ed Eigenbrodt; University of Texas Medical School, Houston, Tex., Susan B. Conley, Jacques Lemire, Ron Portman, Ann Ince, Regina Verani; University of Texas Health Science Center at San Antonio, Tex., Michael Foulds, Sudesh Makker, Kanwal Kher, Melanie Sweet, Victor Saldivar, Fermin Tio; University of Texas Medical Branch, Galveston, Tex., Ben H. Brouhard, Alok Kalia, Luther B. Travis, Lisa Hollander, Tito Cavallo, Srinivasan Rajaraman; University of Utah Medical Center, Salt Lake City, Utah, Eileen Brewer, Miriam Turner, Richard Siegler, Elizabeth Hammond, Theodore Pysher; University of Kentucky College of Medicine, Lexington, Ky., Elizabeth Jackson, Nancy H. Holland, Randall Jenkins, Bonnie Mitchell.

Note: this list reflects the investigators' addresses and positions during the period of this study and not necessarily their current situations.

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Hogg, R.J., Silva, F.G., Wyatt, R.J. et al. Prognostic indicators in children with IgA nephropathy — Report of the Southwest Pediatric Nephrology Study Group. Pediatr Nephrol 8, 15–20 (1994). https://doi.org/10.1007/BF00868251

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Key words

  • IgA nephropathy
  • End-stage renal disease
  • Prognosis