Zidar N, Cavić M A, Kenda R B, Koselj M, Ferluga D
Institute of Pathology, Medical Faculty, University of Ljubljana, Slovenia.
Nephron. 1998;79(1):28-32. doi: 10.1159/000044987.
Intrauterine growth retardation (IUGR) resulting in a reduced number of nephrons is one of the nonimmune mechanisms that have been recently proposed as contributing to the progression of renal diseases. The purpose of our study was to determine whether IUGR has any effect on the clinical course and prognosis of IgA glomerulonephritis (IgA GN) in children. Fifty children with biopsy-proven IgA GN, who were followed for at least 3 years, were included. Six of the 50 children (12%) had signs of IUGR at birth, defined as birth weight below the 10th percentile for gestational age. There were no significant differences in initial clinical presentation between children with IUGR and those without IUGR. However, in kidney biopsy specimens, we found a significantly higher mean percentage of sclerotic glomeruli in children with IUGR than in those without IUGR (33 vs. 13%, p < 0.015). At the end of the follow-up period, we observed a significantly higher incidence of arterial hypertension in children with IUGR than in those without IUGR (50 vs. 11 %, p < 0.05). Other differences between the two groups of children were not statistically significant. In conclusion, our study demonstrated an increased risk of the development of arterial hypertension and glomerulosclerosis in children with IgA GN who had suffered from IUGR with a birth weight below the 10th percentile for gestational age. IUGR may therefore help to identify early in the course of IgA GN those children who are at higher risk of an unfavorable course.
导致肾单位数量减少的宫内生长迟缓（IUGR）是最近被提出的导致肾脏疾病进展的非免疫机制之一。我们研究的目的是确定IUGR是否对儿童IgA肾小球肾炎（IgA GN）的临床病程和预后有任何影响。纳入了50名经活检证实为IgA GN且随访至少3年的儿童。50名儿童中有6名（12%）出生时具有IUGR体征，定义为出生体重低于胎龄的第10百分位数。IUGR儿童与无IUGR儿童的初始临床表现无显著差异。然而，在肾活检标本中，我们发现IUGR儿童的硬化肾小球平均百分比显著高于无IUGR儿童（33%对13%，p<0.015）。在随访期末，我们观察到IUGR儿童的动脉高血压发病率显著高于无IUGR儿童（50%对11%，p<0.05）。两组儿童的其他差异无统计学意义。总之，我们的研究表明，出生体重低于胎龄第10百分位数且患有IUGR的IgA GN儿童发生动脉高血压和肾小球硬化的风险增加。因此，IUGR可能有助于在IgA GN病程早期识别出那些预后不良风险较高的儿童。
