The Oxford Classification predictors of chronic kidney disease in pediatric patients with IgA nephropathy
Journal Title: Jornal de Pediatria - Year 2017, Vol 93, Issue 4
Abstract
Objective The Oxford Classification for Immunoglobulin A nephropathy (IgAN) identifies pathological variables that may predict the decline of renal function. This study aimed to evaluate the Oxford Classification variables as predictors of renal dysfunction in a cohort of Brazilian children and adolescents with IgAN. Methods A total of 54 patients with IgAN biopsied from 1982 to 2010 were assessed. Biopsies were re-evaluated and classified according to the Oxford Classification. Multivariate analysis of laboratory and pathological data was performed. The primary outcomes were decline of baseline estimated glomerular filtration rate (eGFR) greater than or equal to 50%. Results Mean follow-up was 7.6±5.0 years. Mean renal survival was 13.5±0.8 years and probability of decline ≥50% in baseline eGFR was 8% at five years of follow-up and 15% at ten years. Ten children (18.5%) had a decline of baseline eGFR≥50% and five (9.3%) evolved to end-stage renal disease. Kaplan–Meier analysis showed that baseline proteinuria, proteinuria during follow-up, endocapillary proliferation, and tubular atrophy/interstitial fibrosis were associated with the primary outcome. Multivariate Cox analysis showed that only baseline proteinuria (HR, 1.73; 95% CI, 1.20–2.50, p=0.003) and endocapillary hypercellularity (HR, 37.18; 95% CI, 3.85–358.94, p=0.002) were independent predictors of renal dysfunction. No other pathological variable was associated with eGFR decline in the multivariate analysis. Conclusion This is the first cohort study that evaluated the predictive role of the Oxford Classification in pediatric patients with IgAN from South America. Endocapillary proliferation was the unique pathological feature that independently predicted renal outcome.
Authors and Affiliations
Ana Cristina Simões-e-Silva
Keywords
Related Articles
- EP ID EP503568
- DOI 10.1016/j.jped.2016.09.003
- Views 62
- Downloads 0
Clinical and laboratory description of a series of cases of acute viral myositis
Objective Describe the clinical and laboratory profile, follow-up, and outcome of a series of cases of acute viral myositis. Method A retrospective analysis of suspected cases under observation in the emergency departme...
Maternal hypertension and infant growth
Dear Editor, The Jornal de Pediatria published, in its 91st volume, a very interesting article entitled: “Growth of preterm low birth weight infants until 24 months corrected age: effect of maternal hypertension.”1 The a...
Interventions to reduce accidents in childhood: a systematic review
Objective To review the literature on interventions planned to prevent the incidence of injuries in childhood. Source of data The PubMed, Web of Science, and Bireme databases were searched by two independent reviewers,...
Radiologic scales as a tool for the etiologic diagnosis of pediatric community-acquired pneumonia
Dear Editor, The use of chest radiograph as an adjunct method for the diagnosis of pediatric community-acquired pneumonia (CAP) has been highly debated over the past decades. So far, current evidence has demonstrated tha...
Urotherapy in the treatment of children and adolescents with bladder and bowel dysfunction: a systematic review
Objective To identify and describe the protocols and clinical outcomes of urotherapy interventions in children and adolescents with bladder bowel dysfunction. Method Systematic review carried out in June 2018 on Medical...