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논문분류	춘계학술대회 초록집
제목	Treatment outcomes of childhood onset IgA nephropathy and IgA vasculitis from a single tertiary center
저자	Jiwon Jung
출판정보	2024; 2024(1):
키워드
초록	Objectives: Consensus for treatment of childhood onset IgA nephropathy (IgAN) and IgA vasculitis (IgAV) are still laking. Therefore, we aimed to assess the outcomes between the two disease entities from a single tertiary center. Methods: We retrospectively reviewed patients’ medical records with IgAN and IgAV diagnosed between March 2009 and May 2019 from a single center, and compared outcomes and treatment regimens. Results: Overall, 88 patients were included (61 IgAN patients and 27 IgAV patients). The median age of onset was 13.6 (range 2.3-18.3) years, and follow up duration was 4.83 (range 0.17-14.25) years. The median urine protein/creatinine ratio at diagnosis was 1.31 (range 0.28-7.64) mg/mg for IgAV, and 0.8 (range 0.09-5.05) mg/mg for IgAN, respectively. Proteinuria control was achieved at 96.0 % (26/27) in IgAV patients in a median time of 2.92 (range 0.03-15.77) months, while it was achieved at 68.9 % (42/61) in IgAN patients in a median time of 9.25 (range 0.47-120.13) months (p =0.025). While 8.2% of IgAN patients progressed to end stage kidney disease (ESKD), non of the IgAV patients progressed to ESKD. Corticosteroid was used in 61 (69.3 %) patients; 81.4 % (22/27) of patients with IgAV, and 63.9 % (39/61) of patients with IgAN. Additional immunosuppressants were used in 10 (11.3%) patients; 18.5 % (5/27) of patients with IgAN, and 8.2 % (5/61) of patients with IgAN. Regarding the initial pathologic findings, sclerosis from the Oxford classification was more prevalent among IgAN patients (68.9%, 42/61) compared with IgAV patients (9%, 6/27) (p = 0.002). Conclusions: Kidney outcome with IgAV was better than IgAN in children and adolescents, and patients with IgAV were more aggressively managed than with patients with IgAN. Although the two diseases are distinctlively different, more agressive management in childhood onset IgAN might be considered for better outcome.
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