1. Renal thrombotic microangiopathy is associated with poor renal survival in children with immunoglobulin A nephropathy.
- Author
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Yang, Meng, Wang, Le, Sun, Xiong‐Fei, and Yin, Dong‐Qi
- Subjects
IGA glomerulonephritis ,LOGISTIC regression analysis ,CHILD patients ,KIDNEY failure ,KIDNEY diseases - Abstract
Aim: The aim of this study was to examine the clinical and pathological characteristics as well as the prognosis of immunoglobulin A nephropathy (IgAN) accompanied by renal thrombotic microangiopathy (rTMA) in paediatric patients. Methods: After balancing epidemiological characteristics and pathological types between groups, 427 patients (rTMA group: 23, non‐rTMA group: 46) were included. The clinical and pathological features, prognosis and clinical risk factors of the two groups were analysed. Results: IgAN‐rTMA children showed more severe clinical and pathological manifestations. The findings from the logistic regression analysis indicated that hypercellularity 1 (E1) (HR: 0.805, 95% CI: 0.763 ~ 1.452, P =.016), endocapillary proliferation (HR: 1.214, 95% CI: 0.093 ~ 4.815, P =.025) and C3 staining (HR: 7.554, 95% CI: 2.563 ~ 15.729, P =.037) were the risk factors for rTMA in children with IgAN. The renal survival in rTMA group was lower than non‐rTMA group (χ2 = 18.467, P =.000). Cox regression analysis showed that E1 (HR: 7.441, 95% CI: 1.095 ~ 10.768, P =.037), C3 disposition (HR: 3.414, 95% CI: 0.834 ~ 11.578, P =.027) and rTMA (HR: 8.918, 95% CI: 1.032 ~ 16.754, P =.041) were identified as independent risk factors for the development of end‐stage renal disease (ESRD). Conclusion: The presence of rTMA had a significant impact on the severity and prognosis of IgAN. And rTMA has been identified as an independent risk factor for the development of renal failure in children diagnosed with IgAN. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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