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01-06-2015 | Original Article

Risk factors for persistent proteinuria after a 2-year combination therapy for severe childhood IgA nephropathy

Authors: Koichi Kamei, Koichi Nakanishi, Shuichi Ito, Kenji Ishikura, Hiroshi Hataya, Masataka Honda, Kandai Nozu, Kazumoto Iijima, Yuko Shima, Norishige Yoshikawa, for the Japanese Pediatric IgA Nephropathy Treatment Group

Published in: Pediatric Nephrology | Issue 6/2015

Abstract

Background

Although a 2-year combination therapy is effective for severe childhood immunoglobulin A (IgA) nephropathy, proteinuria persists in some patients even after the treatment.

Methods

Seventy-nine patients aged <18 years with IgA nephropathy in which >80 % of glomeruli showed mesangial proliferation were enrolled in the study. Risk factors for persistent proteinuria after combination therapy were investigated using multivariate logistic regression analysis.

Results

Proteinuria (≥0.2 g/1.73 m²/day) persisted in 27 patients (34 %) after the combination therapy. Twenty-four-hour urinary protein excretion, rate of glomeruli with crescents, rate of glomeruli with segmental sclerosis and rate of glomeruli with global sclerosis at diagnosis were higher in patients with persistent proteinuria than those without. In the multivariate analysis, 24-h urinary protein excretion [odds ratio (OR) 6.9; 95 % confidence interval (CI) 2.1–27.8; p = 0.001] and rate of glomeruli with crescents (OR 3.8; 95 % CI 1.1–13.9; p = 0.03) were independent risk factors for persistent proteinuria. Analysis of the receiver operating characteristic curve demonstrated that the most accurate cut-off values to detect persistent proteinuria were a urinary protein excretion of 1.32 g/1.73 m²/day and a 14 % rate of glomeruli with crescents.

Conclusions

In our cohort, urinary protein excretion and rate of glomeruli with crescents at diagnosis were independent risk factors for persistent proteinuria after the combination therapy.

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Title: Risk factors for persistent proteinuria after a 2-year combination therapy for severe childhood IgA nephropathy
Authors: Koichi Kamei
Koichi Nakanishi
Shuichi Ito
Kenji Ishikura
Hiroshi Hataya
Masataka Honda
Kandai Nozu
Kazumoto Iijima
Yuko Shima
Norishige Yoshikawa
for the Japanese Pediatric IgA Nephropathy Treatment Group
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 6/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-3019-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Risk factors for persistent proteinuria after a 2-year combination therapy for severe childhood IgA nephropathy

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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