Comparative histological and clinical differences between children and adults in IgA nephropathy

Abstract

IgA nephropathy (IgAN), as an autoimmune-mediated kidney disease worldwide, is considered an important cause of end-stage renal disease in adults. The most important diagnostic method in the patients is the evaluation of the biopsy findings. To date, several studies have examined different histopathological findings in patients with IgAN with an attempt to find out the relationship between morphologic findings with outcome and disease progression. Although there have been limited reports of IgAN in children, the Oxford scoring system is currently the most widely used IgAN classification and is validated for use in children and adults. In this review, we examined the most frequently published pathological findings on IgAN with a focus on Oxford classification between adults and children and attempted to highlight the key differences. The main purpose of this study was to assess the prognosis of patients with IgAN in childhood and adulthood, with emphasis on pathological risk factors for disease progression. Our results indicated that acute glomerulonephritis in children was predominantly reported more than chronic lesions. In addition, mesangial and endocapillary lesions were more common in children than in adults. In contrast, glomerular sclerosis, tubular atrophy/interstitial fibrosis, and atherosclerotic lesions were more common in older individuals.

Keywords: Immunoglobulin A nephropathy, Pediatrics, IgA nephropathy, Oxford classification, End-stage renal disease