Unknown

Dataset Information

0

Hypertension/prehypertension and its determinants in pediatric IgA nephropathy.


ABSTRACT: Immunoglobulin A nephropathy (IgAN) is a major cause of secondary hypertension (HT) of renal origin - a significant prognostic factor of IgAN. In children, similar to HT, prehypertension (pre-HT) is becoming a significant health issue. However, the role of secondary HT and pre-HT (HT/pre-HT) in the progression of pediatric IgAN remains unclear. We investigated the effects of HT/pre-HT on prognosis and its determinants as well as their correlation with clinicopathological parameters to identify more effective therapeutic targets.This single-center retrospective study compared clinicopathological features and treatment outcomes between patients with and without HT/pre-HT in 108 children with IgAN. Independent risk factors for HT/pre-HT were evaluated; segmental glomerulosclerosis was a significant variable, whose relationship with clinicopathological parameters was analyzed.Clinical outcomes of patients with and without HT/pre-HT differed considerably (P = .006) on ≥6 months follow-up. Patients with HT/pre-HT reached complete remission less frequently than those without HT/pre-HT (P = .014). Age, serum creatinine, prothrombin time, and segmental glomerulosclerosis or adhesion were independent risk factors for HT/pre-HT in pediatric IgAN (P = .012, P = .017, P = .002, and P = .016, respectively). Segmental glomerulosclerosis or adhesion was most closely associated with glomerular crescents (r = 0.456, P < .01), followed by Lees grades (r = 0.454, P < .01), renal arteriolar wall thickening (r = 0.337, P < .01), and endocapillary hypercellularity (r = 0.306, P = .001). The intensity of IgA deposits, an important marker of pathogenetic activity in IgAN, was significantly associated with the intensity and location of fibrinogen deposits (intensity: r = 0.291, P = .002; location: r = 0.275, P = .004).HT/pre-HT in pediatric IgAN patients is an important modifiable factor. A relationship is observed between HT/pre-HT and its determinants, especially segmental glomerulosclerosis. Potential therapeutic approaches for IgAN with HT/pre-HT might be directed toward the management of coagulation status, active lesions, and hemodynamics for slowing disease progression.

SUBMITTER: Fu QY 

PROVIDER: S-EPMC7535649 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

altmetric image

Publications

Hypertension/prehypertension and its determinants in pediatric IgA nephropathy.

Fu Qing-Ying QY   Ma Lu L   Li Chang-Chun CC   He Zhi-Jun ZJ   Wang Wei-Hua WH   Luo Kai-Fa KF   Liu Yang Y   Zhang Zhi-Hao ZH   Yang Zai-Bo ZB   Tang Hai-Lian HL   Yan Jun-Hui JH  

Medicine 20201001 40


Immunoglobulin A nephropathy (IgAN) is a major cause of secondary hypertension (HT) of renal origin - a significant prognostic factor of IgAN. In children, similar to HT, prehypertension (pre-HT) is becoming a significant health issue. However, the role of secondary HT and pre-HT (HT/pre-HT) in the progression of pediatric IgAN remains unclear. We investigated the effects of HT/pre-HT on prognosis and its determinants as well as their correlation with clinicopathological parameters to identify m  ...[more]

Similar Datasets

| S-EPMC2441593 | biostudies-other
| S-EPMC5383386 | biostudies-literature
| S-EPMC10647220 | biostudies-literature
| S-EPMC7837486 | biostudies-literature
| S-EPMC7000803 | biostudies-literature
| S-EPMC11898040 | biostudies-literature
| S-EPMC10690074 | biostudies-literature
| S-EPMC8462925 | biostudies-literature
| S-EPMC3203630 | biostudies-literature
| S-EPMC7490786 | biostudies-literature