Yoshikawa N, Ito H, Iijima K, Nakahara C, Maehara K, Hasegawa O, Okada S, Matsuo T
Department of Pediatrics, Kobe University Hospital, Japan.
Clin Nephrol. 1987 Nov;28(5):217-21.
The clinical presentation, initial laboratory and renal biopsy findings, and subsequent clinical course in 205 children with IgA nephropathy were studied retrospectively. The findings in the 119 patients with macroscopic hematuria and those in the 86 without macroscopic hematuria were compared. There were no differences with regard to sex distribution, age at onset, initial renal function, incidence of hypertension, degree of proteinuria and degree of mesangial proliferation. At the latest follow-up, 3% of the patients with macroscopic hematuria and 8% without macroscopic hematuria had developed chronic renal failure; 8% of the patients with macroscopic hematuria and 20% without had heavy proteinuria with or without hypertension (p less than 0.01); 41% of the patients with macroscopic hematuria and 24% without macroscopic hematuria had normal urine, blood pressure and GFR (p less than 0.05). The disease appears to follow a significantly more benign course in children with macroscopic hematuria than in those without macroscopic hematuria. These observations suggest some macroscopic hematuria-related differences in the natural history of childhood IgA nephropathy.
对205例IgA肾病患儿的临床表现、初始实验室检查及肾活检结果，以及后续临床病程进行了回顾性研究。比较了119例肉眼血尿患儿和86例无肉眼血尿患儿的检查结果。在性别分布、发病年龄、初始肾功能、高血压发病率、蛋白尿程度和系膜增生程度方面无差异。在最近一次随访时，肉眼血尿患儿中有3%、无肉眼血尿患儿中有8%发展为慢性肾衰竭；肉眼血尿患儿中有8%、无肉眼血尿患儿中有20%出现大量蛋白尿伴或不伴高血压（p<0.01）；肉眼血尿患儿中有41%、无肉眼血尿患儿中有24%的尿液、血压和肾小球滤过率（GFR）正常（p<0.05）。与无肉眼血尿的患儿相比，肉眼血尿患儿的疾病进程明显更为良性。这些观察结果提示，儿童IgA肾病自然病程中存在一些与肉眼血尿相关的差异。
