机构：[1]Department of Pediatric Nephrology, Peking University First Hospital, No. 1 Xi An Men Da Jie, Beijing 100034, People’s Republic of China[2]Renal Division, Peking University First Hospital, No.8 Xi Shi Ku Da Jie, Beijing 100034, People’s Republic of China[3]Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China[4]Department of Nephrology, Rheumatology and Immunology, Hunan Children’s Hospital, Changsha, Hunan, China[5]Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, Hubei Province, China华中科技大学同济医学院附属同济医院[6]Department of Pediatric Nephrology and Rheumatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China中山大学附属第一医院[7]Department of Pediatric Nephrology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 611731, China[8]Pediatric Nephrology Department, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510623, Guangdong, China[9]Department of Pediatric Nephrology and Rheumatism and Immunology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, China[10]Nephrology and Immunology Department, Children’s Hospital of Hebei Province, Shijiazhuang, Hebei Province, China[11]Department of Pediatrics, Jinling Hospital, Medical School of Nanjing University, Nanjing, China[12]Department of Nephrology, Children Hospital of Zhejiang University School of Medicine, Hangzhou, China[13]Department of Nephrology and Rheumatology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China[14]Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China[15]Department of Nephrology, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China首都儿科研究所[16]Department of Pediatric, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, China[17]Department of Nephrology, Children’s Hospital of Chongqing Medical University, Chongqing, China[18]Department of Pediatrics, The First People’s Hospital of Yunnan Province, The Affiliated Hospital of Kunming Science and Technology University, Kunming, China内科片儿科云南省第一人民医院[19]Department of Pediatric Nephrology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China[20]Department of Pediatrics, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou 350025, China[21]Department of Nephrology, Rheumatology and Immunology, Fujian Children’s Hospital, Fuzhou 350014, China[22]Department of Pediatric Nephrology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, Hubei, China[23]Department of Nephrology, Xi’an Children’s Hospital, Xian, Shaanxi, China[24]Department of Pediatric Nephrology, Beijing Children’s Hospital, Capital Medical University, Beijing, China首都医科大学附属北京儿童医院[25]Department of Nephrology, Anhui Provincial Children’s Hospital, Hefei, China[26]Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China[27]Department of Pediatric Nephrology, The First Hospital of Jilin University, Changchun, China[28]Department of General Medicine, Tianjin Children’s Hospital, Tianjin, China[29]Department of Nephrology, Xuzhou Children’s Hospital, Xuzhou Medical University, Xuzhou, China[30]Department of Nephrology, Jiangxi Provincial Children’s Hospital, Nanchang 330006, China[31]Medical Data Science Center, Medical Research Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
Background Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN. Methods We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN. Results A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m(2), p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids. Conclusions Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children.
基金：
This work was funded by the National Key Research and Development
Program of China (2022YFC 2705100, 2022YFC 2705104) and
the Beijing Natural Science Foundation (Z190023).
第一作者机构：[1]Department of Pediatric Nephrology, Peking University First Hospital, No. 1 Xi An Men Da Jie, Beijing 100034, People’s Republic of China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Su Baige,Jiang Yuanyuan,Li Zhihui,et al.Are children with IgA nephropathy different from adult patients?[J].PEDIATRIC NEPHROLOGY.2024,39(8):2403-2412.doi:10.1007/s00467-024-06361-1.
APA：
Su, Baige,Jiang, Yuanyuan,Li, Zhihui,Zhou, Jianhua,Rong, Liping...&Zhang, Hong.(2024).Are children with IgA nephropathy different from adult patients?.PEDIATRIC NEPHROLOGY,39,(8)
MLA：
Su, Baige,et al."Are children with IgA nephropathy different from adult patients?".PEDIATRIC NEPHROLOGY 39..8(2024):2403-2412
