The Oxford IgA nephropathy clinicopathological classification is valid for children as well as adults

被引：142

作者：

Coppo, Rosanna ^{[1
]}

Troyanov, Stephan ^{[2
]}

Camilla, Roberta ^{[1
]}

Hogg, Ronald J. ^{[3
]}

Cattran, Daniel C. ^{[4
]}

Cook, H. Terence ^{[5
]}

Feehally, John ^{[6
]}

Roberts, Ian S. D. ^{[7
]}

Amore, Alessandro ^{[1
]}

Alpers, Charles E. ^{[8
]}

Barratt, Jonathan ^{[6
]}

Berthoux, Francois ^{[9
]}

Bonsib, Stephen ^{[10
]}

Bruijn, Jan A. ^{[11
]}

D'Agati, Vivette ^{[12
]}

D'Amico, Giuseppe ^{[13
]}

Emancipator, Steven N. ^{[14
]}

Emma, Francesco ^{[15
]}

Ferrario, Franco ^{[16
]}

Fervenza, Fernando C. ^{[17
]}

Florquin, Sandrine ^{[18
]}

Fogo, Agnes B. ^{[19
]}

Geddes, Colin C. ^{[20
]}

Groene, Hermann J. ^{[21
]}

Haas, Mark ^{[22
]}

Herzenberg, Andrew M. ^{[23
,24
]}

Hill, Prue A. ^{[25
]}

Hsu, Stephen I. ^{[26
]}

Jennette, J. Charles ^{[27
]}

Joh, Kensuke ^{[28
]}

Julian, Bruce A. ^{[29
]}

Kawamura, Tetsuya ^{[30
]}

Lai, Fernand M. ^{[31
]}

Li, Lei S. ^{[32
]}

Li, Philip K. ^{[33
]}

Liu, Zhi H. ^{[32
]}

Mezzano, Sergio ^{[34
]}

Schena, F. Paolo ^{[35
]}

Tomino, Yasuhiko ^{[36
]}

Walker, Patrick D. ^{[38
]}

Wang, Haiyan ^{[37
]}

Weening, Jan J. ^{[39
]}

Yoshikawa, Norishige ^{[40
]}

Zhang, Hong ^{[37
]}

机构：

[1] Regina Margherita Childrens Hosp, Transplant Unit, I-10126 Turin, Italy

[2] Univ Montreal, Hop Sacre Coeur Montreal, Montreal, PQ, Canada

[3] Scott & White Med Ctr, Temple, TX USA

[4] Univ Hlth Network, Toronto Gen Res Inst, Toronto, ON, Canada

[5] Univ London Imperial Coll Sci Technol & Med, Dept Histopathol, London, England

[6] Leicester Gen Hosp, John Walls Renal Unit, Leicester LE5 4PW, Leics, England

[7] John Radcliffe Hosp, Dept Cellular Pathol, Oxford OX3 9DU, England

[8] Univ Washington, Med Ctr, Dept Pathol, Seattle, WA 98195 USA

[9] CHU St Etienne, Dept Nephrol Dialysis & Transplantat, Hop Nord, St Etienne, France

[10] LSU Hlth Sci Ctr, Dept Pathol, Shreveport, LA USA

[11] Leiden Univ, Dept Pathol, Med Ctr, Leiden, Netherlands

[12] Columbia Univ Coll Phys & Surg, Dept Pathol, New York, NY 10032 USA

[13] Fdn DAmico Ric Malattie Renali, Milan, Italy

[14] Case Western Reserve Univ, Dept Pathol, Cleveland, OH 44106 USA

[15] Bambin Gesu Childrens Hosp, Rome, Italy

[16] San Carlo Borromeo Hosp, Renal Immunopathol Ctr, Milan, Italy

[17] Mayo Clin, Div Nephrol & Hypertens, Rochester, MN USA

[18] Univ Amsterdam, Acad Med Ctr, Dept Pathol, NL-1105 AZ Amsterdam, Netherlands

[19] Vanderbilt Univ, Dept Pathol, Nashville, TN USA

[20] Univ Glasgow, Western Infirm, Renal Unit, Glasgow G11 6NT, Lanark, Scotland

[21] German Canc Res Ctr, Dept Cellular & Mol Pathol, D-6900 Heidelberg, Germany

[22] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA

[23] Univ Hlth Network, Dept Pathol, Toronto, ON, Canada

[24] Univ Toronto, Toronto, ON, Canada

[25] St Vincents Hosp, Melbourne, Vic, Australia

[26] Univ Florida, Coll Med, Div Nephrol Hypertens & Renal Transplantat, Gainesville, FL USA

[27] Univ N Carolina, Dept Pathol & Lab Med, Chapel Hill, NC USA

[28] E Natl Hosp, Div Immunopathol, Clin Res Ctr Chiba, Chiba, Japan

[29] Univ Alabama Birmingham, Dept Med, Div Nephrol, Birmingham, AL 35294 USA

[30] Jikei Univ, Div Nephrol & Hypertens, Sch Med, Tokyo, Japan

[31] Chinese Univ Hong Kong, Dept Anat & Cellular Pathol, Hong Kong, Hong Kong, Peoples R China

[32] Nanjing Univ, Res Inst Nephrol, Jinling Hosp, Sch Med, Nanjing 210008, Peoples R China

[33] Chinese Univ Hong Kong, Dept Med, Prince Wales Hosp, Hong Kong, Hong Kong, Peoples R China

[34] Univ Austral Chile, Dept Nefrol, Escuela Med, Valdivia, Chile

[35] Univ Bari, Renal Dialysis & Transplant Unit, Bari, Italy

[36] Juntendo Univ, Sch Med, Div Nephrol, Dept Internal Med, Tokyo 113, Japan

[37] Peking Univ, Div Renal, Hosp 1, Inst Nephrol, Beijing 100871, Peoples R China

[38] Nephropathol Associates, Little Rock, AR USA

[39] Erasmus MC, Rotterdam, Netherlands

[40] Wakayama Med Univ, Dept Pediat, Wakayama, Japan

来源：

KIDNEY INTERNATIONAL | 2010年 / 77卷 / 10期

基金：

日本学术振兴会;

关键词：

children; histopathology; IgA nephropathy; renal biopsy; GLOMERULAR-FILTRATION-RATE; RENAL BIOPSIES; FEATURES; PROGNOSIS; JAPANESE;

D O I：

10.1038/ki.2010.43

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

To study the predictive value of biopsy lesions in IgA nephropathy in a range of patient ages we retrospectively analyzed the cohort that was used to derive a new classification system for IgA nephropathy. A total of 206 adults and 59 children with proteinuria over 0.5 g/24h/1.73 m(2) and an eGFR of stage-3 or better were followed for a median of 69 months. At the time of biopsy, compared with adults children had a more frequent history of macroscopic hematuria, lower adjusted blood pressure, and higher eGFR but similar proteinuria. Although their outcome was similar to that of adults, children had received more immunosuppressants and achieved a lower follow-up proteinuria. Renal biopsies were scored for variables identified by an iterative process as reproducible and independent of other lesions. Compared with adults, children had significantly more mesangial and endocapillary hypercellularity, and less segmental glomerulosclerosis and tubulointerstitial damage, the four variables previously identified to predict outcome independent of clinical assessment. Despite these differences, our study found that the cross-sectional correlation between pathology and proteinuria was similar in adults and children. The predictive value of each specific lesion on the rate of decline of renal function or renal survival in IgA nephropathy was not different between children and adults. Kidney International (2010) 77, 921-927; doi: 10.1038/ki.2010.43; published online 3 March 2010

引用

页码：921 / 927

页数：7

共 20 条

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