ESPN 50th Annual Meeting

ESPN 2017


 
IGA NEPHROPATHY IN CHILDREN IN THE CZECH REGISTRY OF RENAL BIOPSIES (CRRB)
ALEXANDER KOLSKY 1 EVA JANCOVA 2 JIRI DUSEK 3 JIRI STARHA 4 SYLVA SKALOVA 5 KAREL VONDRAK 3 JAKUB ZIEG 3 HANA FLOGELOVA 6 NADEZDA SIMANKOVA 3 TEREZIE SULAKOVA 7 EVA SLADKOVA 8 VLADIMIR SMRCKA 9 JELENA SKIBOVA 10

1- DEPT. OF PAEDIATRICS, 3RD MEDICAL FACULTY, CHARLES UNIVERSITY, FNKV, PRAGUE 10
2- DEPT. OF NEPHROLOGY, 1ST FACULTY OF MEDICINE CHARLES UNI, VFN, PRAGUE 2
3- DEPT. OF PAEDIATRICS, 2ND FACULTY OF MEDICINE CHARLES UNI, FNM, PRAGUE 5
4- DEPT. OF PAEDIATRICS, MASARYK UNI, BRNO
5- DEPT. OF PAEDIATRICS, CHARLES UNI, HRADEC KRALOVE
6- DEPT. OF PAEDIATRICS PALACKY UNI, OLOMOUC
7- DEPT. OF PAEDIATRICS, TEACHING HOSP. OSTRAVA
8- DEPT. OF PAEDIATRICS, CHARLES UNI, PLZEN
9- DEPT. OF PAEDIATRICS, HOSP. CESKE BUDEJOVICE
10- INSTITUTE FOR CLINICAL AND EXPERIMENTAL MEDICINE, PRAGUE 4
 
Introduction:

To analyze cases of IgA nephropathy (IgAGN) in the CRRB. The CRRB includes data from 2197 renal biopsies (RBs), performed between 1994 and 2012, in children and adolescents aged ≤18 years. CRRB currently contains data of native kidneys in the Czech Republic of 11 paediatric centers performing practically all RBs in children.

Material and methods:

These data are already available for 540 RBs conducted in the 2007–2012 period.

Results:

IgAGN, is the most common diagnosis, was found in 92 (17%) RBs. The mean age of IgAGN patients (73.9% of boys) was 13.7±3.7 years (2.5 months–18 yrs), 2% were 5 yrs, 11.9 % were 5–10 yrs, 30.8% were 10–15 yrs, and 55.2% were ≤18 yrs old. At the time of RB, 59.7% of children with IgAGN had microscopic hematuria and 36% gross hematuria. Proteinuria 1–3 g/24h was present in 48.9% of children and nephrotic proteinuria in 13.1%, with 1.2% of children meeting the criteria of nephrotic syndrome. Most RBs were classified as IgAGN (67.6%), with only a minority further characterized as: mesangioproliferative GN in 19.7%, with membranoproliferative GN features in 1.2%, with crescents in 1.8%, with sclerotization in 4.3%, and as a combination of several of the above types in 5.3%. At the time of RB in the 93 children with IgAGN 18.5% had hypertension (HT), with 15.2% of these treated for HT. Those with HT had lower glomerular filtration rate (GFR) (Schwartz formula, 1.47±0.72 vs. normotensive 1.62±0.52 ml/s/1.73m2; p<0.05) and significantly higher proteinuria (89.92±113.52 vs. normotensive 33.13±50.46 mg/m2/h; p<0.01).

Conclusions:

IgAGN is the most common diagnosis in the CRRB. HT is associated with known risk factors for progression of biopsy-proven GN such as GFR or proteinuria. CRRB provides us with important information about the epidemiology of glomerulonephritis in our region, and represents a basis for cooperation in this field.