nach oben

Erschienen in:

18.02.2019 | Review

Steroid therapy in children with IgA nephropathy

verfasst von: Alexandra Cambier, Olivia Boyer, Georges Deschenes, James Gleeson, Anne Couderc, Julien Hogan, Thomas Robert

Erschienen in: Pediatric Nephrology | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

IgA nephropathy (IgAN) is one the most common primary glomerulonephritis in children and adolescents worldwide, with 20% of children developing end-stage kidney disease (ESKD) within 20 years of diagnosis. There is a need for treatment guidelines, especially for steroids in children with primary IgAN, since the STOP-IgA trial casts doubts on the use of steroids in adults with intermediate risk. Pediatricians are prone to prescribe steroids in addition to renin–angiotensin system blockade (RASB) when proteinuria is > 0.5 g/l, eGFR deteriorates < 70 ml/min/1.73 m², or when a biopsy sample shows glomerular inflammation. Lack of randomized controlled trials (RCTs) in children with IgAN has led to an absence of consensus on the use of immunosuppressive agents in the treatment of progressive IgAN. This literature review evaluates the available evidence on steroid treatment in children with IgAN.

Berger J, Hinglais N (1968) Intercapillary deposits of IgA-IgG. J Urol Nephrol 74:694–695

Shen H, Gu W, Mao J, Zhu X, Jin X, Fu H, Liu A, Shu Q, Du L (2015) Clinical characteristics of concomitant nephrotic IgA nephropathy and minimal change disease in children. Nephron 130:21–28. https://doi.org/10.1159/000382035CrossRefPubMed

Wenderfer SE, Gaut JP (2017) Glomerular diseases in children. Adv Chronic Kidney Dis 24:364–371. https://doi.org/10.1053/j.ackd.2017.09.005CrossRefPubMed

Santangelo L, Netti GS, Giordano P, Carbone V, Martino M, Torres DD, Rossini M, Di Palma AM, Gesualdo L, Giordano M (2018) Indications and results of renal biopsy in children: a 36-year experience. World J Pediatr 14:127–133. https://doi.org/10.1007/s12519-018-0147-5CrossRefPubMed

Delos Santos NM, Wyatt RJ (2004) Pediatric IgA nephropathies: clinical aspects and therapeutic approaches. Semin Nephrol 24:269–286CrossRef

Cho BS, Hahn WH, Cheong HI, Lim I, Ko CW, Kim SY, Lee DY, Ha TS, Suh JS (2013) A nationwide study of mass urine screening tests on Korean school children and implications for chronic kidney disease management. Clin Exp Nephrol 17:205–210. https://doi.org/10.1007/s10157-012-0672-9CrossRefPubMed

Yoshikawa N, Tanaka R, Iijima K (2001) Pathophysiology and treatment of IgA nephropathy in children. Pediatr Nephrol 16:446–457CrossRef

Coppo R, Gianoglio B, Porcellini MG, Maringhini S (1998) Frequency of renal diseases and clinical indications for renal biopsy in children (report of the Italian National Registry of Renal Biopsies in Children). Group of Renal Immunopathology of the Italian Society of Pediatric Nephrology and Group of Renal Immunopathology of the Italian Society of Nephrology. Nephrol Dial Transplant 13:293–297CrossRef

Yamagata K, Iseki K, Nitta K, Imai H, Iino Y, Matsuo S, Makino H, Hishida A (2008) Chronic kidney disease perspectives in Japan and the importance of urinalysis screening. Clin Exp Nephrol 12:1–8. https://doi.org/10.1007/s10157-007-0010-9CrossRefPubMed

10.

Coppo R (2008) Pediatric IgA nephropathy: clinical and therapeutic perspectives. Semin Nephrol 28:18–26. https://doi.org/10.1016/j.semnephrol.2007.10.003CrossRefPubMed

11.

Robert T, Berthelot L, Cambier A, Rondeau E, Monteiro RC (2015) Molecular insights into the pathogenesis of IgA nephropathy. Trends Mol Med 21:762–775. https://doi.org/10.1016/j.molmed.2015.10.003CrossRefPubMed

12.

Nakata J, Suzuki Y, Suzuki H, Sato D, Kano T, Yanagawa H, Matsuzaki K, Horikoshi S, Novak J, Tomino Y (2014) Changes in nephritogenic serum galactose-deficient IgA1 in IgA nephropathy following tonsillectomy and steroid therapy. PLoS One 9:e89707. https://doi.org/10.1371/journal.pone.0089707CrossRefPubMedPubMedCentral

13.

Berthoux F, Suzuki H, Thibaudin L, Yanagawa H, Maillard N, Mariat C, Tomino Y, Julian BA, Novak J (2012) Autoantibodies targeting galactose-deficient IgA1 associate with progression of IgA nephropathy. J Am Soc Nephrol 23:1579–1587. https://doi.org/10.1681/ASN.2012010053CrossRefPubMedPubMedCentral

14.

Coppo R, Amore A, Gianoglio B, Cacace G, Picciotto G, Roccatello D, Peruzzi L, Piccoli G, De Filippi PG (1993) Angiotensin II local hyperreactivity in the progression of IgA nephropathy. Am J Kidney Dis 21:593–602CrossRef

15.

Tanaka S, Ninomiya T, Katafuchi R, Masutani K, Nagata M, Tsuchimoto A, Hirakata H, Kitazono T, Tsuruya K (2016) The effect of renin-angiotensin system blockade on the incidence of end-stage renal disease in IgA nephropathy. Clin Exp Nephrol 20:689–698. https://doi.org/10.1007/s10157-015-1195-yCrossRefPubMed

16.

Higa A, Shima Y, Hama T, Sato M, Mukaiyama H, Togawa H, Tanaka R, Nozu K, Sako M, Iijima K, Nakanishi K, Yoshikawa N (2015) Long-term outcome of childhood IgA nephropathy with minimal proteinuria. Pediatr Nephrol 30:2121–2127. https://doi.org/10.1007/s00467-015-3176-5CrossRefPubMed

17.

Nakanishi K, Iijima K, Ishikura K, Hataya H, Awazu M, Sako M, Honda M, Yoshikawa N, Japanese Pediatric IgA Nephropathy Treatment Study Group (2009) Efficacy and safety of lisinopril for mild childhood IgA nephropathy: a pilot study. Pediatr Nephrol 24:845–849. https://doi.org/10.1007/s00467-008-1006-8CrossRefPubMed

18.

Coppo R, Peruzzi L, Amore A, Piccoli A, Cochat P, Stone R, Kirschstein M, Linné T (2007) IgACE: a placebo-controlled, randomized trial of angiotensin-converting enzyme inhibitors in children and young people with IgA nephropathy and moderate proteinuria. J Am Soc Nephrol 18:1880–1888. https://doi.org/10.1681/ASN.2006040347CrossRefPubMed

19.

Mitsnefes MM, Laskin BL, Dahhou M, Zhang X, Foster BJ (2013) Mortality risk among children initially treated with dialysis for end-stage kidney disease, 1990-2010. JAMA 309:1921–1929. https://doi.org/10.1001/jama.2013.4208CrossRefPubMedPubMedCentral

20.

Shima Y, Nakanishi K, Hama T, Mukaiyama H, Togawa H, Sako M, Kaito H, Nozu K, Tanaka R, Iijima K, Yoshikawa N (2013) Spontaneous remission in children with IgA nephropathy. Pediatr Nephrol 28:71–76. https://doi.org/10.1007/s00467-012-2294-6CrossRefPubMed

21.

Waldo FB, Wyatt RJ, Kelly DR, Herrera GA, Benfield MR, Kohaut EC (1993) Treatment of IgA nephropathy in children: efficacy of alternate-day oral prednisone. Pediatr Nephrol 7:529–532CrossRef

22.

Waldo FB, Alexander R, Wyatt RJ, Kohaut EC (1989) Alternate-day prednisone therapy in children with IgA-associated nephritis. Am J Kidney Dis 13:55–60CrossRef

23.

Tesar V, Troyanov S, Bellur S, Verhave JC, Cook HT, Feehally J, Roberts IS, Cattran D, Coppo R, VALIGA study of the ERA-EDTA Immunonephrology Working Group (2015) Corticosteroids in IgA nephropathy: a retrospective analysis from the VALIGA study. J Am Soc Nephrol 26:2248–2258. https://doi.org/10.1681/ASN.2014070697CrossRefPubMedPubMedCentral

24.

Yoshikawa N, Ito H, Sakai T, Takekoshi Y, Honda M, Awazu M, Ito K, Iitaka K, Koitabashi Y, Yamaoka K, Nakagawa K, Nakamura H, Matsuyama S, Seino Y, Takeda N, Hattori S, Ninomiya M (1999) A controlled trial of combined therapy for newly diagnosed severe childhood IgA nephropathy. The Japanese Pediatric IgA Nephropathy Treatment Study Group. J Am Soc Nephrol 10:101–109PubMed

25.

Yoshikawa N, Honda M, Iijima K, Awazu M, Hattori S, Nakanishi K, Ito H, Japanese Pediatric IgA Nephropathy Treatment Study Group (2006) Steroid treatment for severe childhood IgA nephropathy: a randomized, controlled trial. Clin J Am Soc Nephrol 1:511–517. https://doi.org/10.2215/CJN.01120905CrossRefPubMed

26.

Coppo R, Lofaro D, Camilla RR, Bellur S, Cattran D, Cook HT, Roberts IS, Peruzzi L, Amore A, Emma F, Fuiano L, Berg U, Topaloglu R, Bilginer Y, Gesualdo L, Polci R, Mizerska-Wasiak M, Caliskan Y, Lundberg S, Cancarini G, Geddes C, Wetzels J, Wiecek A, Durlik M, Cusinato S, Rollino C, Maggio M, Praga M, H KS, Tesar V, Maixnerova D, Barratt J, Papalia T, Bonofiglio R, Mazzucco G, Giannakakis C, Soderberg M, Orhan D, Di Palma AM, Maldyk J, Ozluk Y, Sudelin B, Tardanico R, Kipgen D, Steenbergen E, Karkoszka H, Perkowska-Ptasinska A, Ferrario F, Gutierrez E, Honsova E (2017) Risk factors for progression in children and young adults with IgA nephropathy: an analysis of 261 cases from the VALIGA European cohort. Pediatr Nephrol 32:139–150. https://doi.org/10.1007/s00467-016-3469-3CrossRefPubMed

27.

Cambier A, Rabant M, Peuchmaur M, Hertig A, Deschenes G, Couchoud C, Kolko A, Salomon R, Hogan J, Robert T (2018) Immunosuppressive treatment in children with IgA nephropathy and the clinical value of podocytopathic features. Kidney Int Rep 3:916–925. https://doi.org/10.1016/j.ekir.2018.03.013CrossRefPubMedPubMedCentral

28.

Yata N, Nakanishi K, Shima Y, Togawa H, Obana M, Sako M, Nozu K, Tanaka R, Iijima K, Yoshikawa N (2008) Improved renal survival in Japanese children with IgA nephropathy. Pediatr Nephrol 23:905–912. https://doi.org/10.1007/s00467-007-0726-5CrossRefPubMedPubMedCentral

29.

Kamei K, Nakanishi K, Ito S, Saito M, Sako M, Ishikura K, Hataya H, Honda M, Iijima K, Yoshikawa N, Japanese Pediatric IgA Nephropathy Treatment Study Group (2011) Long-term results of a randomized controlled trial in childhood IgA nephropathy. Clin J Am Soc Nephrol 6:1301–1307. https://doi.org/10.2215/CJN.08630910CrossRefPubMedPubMedCentral

30.

Coppo R (2017) Clinical and histological risk factors for progression of IgA nephropathy: an update in children, young and adult patients. J Nephrol 30:339–346. https://doi.org/10.1007/s40620-016-0360-zCrossRefPubMed

31.

Lv J, Xu D, Perkovic V, Ma X, Johnson DW, Woodward M, Levin A, Zhang H, Wang H, TESTING Study Group (2012) Corticosteroid therapy in IgA nephropathy. J Am Soc Nephrol 23:1108–1116. https://doi.org/10.1681/ASN.2011111112CrossRefPubMedPubMedCentral

32.

Liu D, Ahmet A, Ward L, Krishnamoorthy P, Mandelcorn ED, Leigh R, Brown JP, Cohen A, Kim H (2013) A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy, Asthma Clin Immunol 9:30. https://doi.org/10.1186/1710-1492-9-30CrossRef

33.

Noone DG, Iijima K, Parekh R (2018) Idiopathic nephrotic syndrome in children. Lancet 392:61–74. https://doi.org/10.1016/S0140-6736(18)30536-1CrossRefPubMed

34.

Yoshikawa N, Iijima K, Maehara K, Yoshiara S, Yoshiya K, Matsuo T, Okada S (1987) Mesangial changes in IgA nephropathy in children. Kidney Int 32:585–589CrossRef

35.

Wyatt RJ, Kritchevsky SB, Woodford SY, Miller PM, Roy S 3rd, Holland NH, Jackson E, Bishof NA (1995) IgA nephropathy: long-term prognosis for pediatric patients. J Pediatr 127:913–919CrossRef

36.

Kim JK, Kim JH, Lee SC, Kang EW, Chang TI, Moon SJ, Yoon SY, Yoo TH, Kang SW, Choi KH, Han DS, Kie JH, Lim BJ, Jeong HJ, Han SH (2012) Clinical features and outcomes of IgA nephropathy with nephrotic syndrome. Clin J Am Soc Nephrol 7:427–436. https://doi.org/10.2215/CJN.04820511CrossRefPubMedPubMedCentral

37.

Kang Z, Li Z, Duan C, Wu T, Xun M, Ding Y, Zhang Y, Zhang L, Yin Y (2015) Mycophenolate mofetil therapy for steroid-resistant IgA nephropathy with the nephrotic syndrome in children. Pediatr Nephrol 30:1121–1129. https://doi.org/10.1007/s00467-014-3041-yCrossRefPubMedPubMedCentral

38.

Shima Y, Nakanishi K, Sato M, Hama T, Mukaiyama H, Togawa H, Tanaka R, Nozu K, Sako M, Iijima K, Suzuki H, Yoshikawa N (2017) IgA nephropathy with presentation of nephrotic syndrome at onset in children. Pediatr Nephrol 32:457–465. https://doi.org/10.1007/s00467-016-3502-6CrossRefPubMed

39.

(2012) Chapter 10: immunoglobulin A nephropathy. Kidney Int Suppl 2:209–217. https://doi.org/10.1038/kisup.2012.23

40.

Herlitz LC, Bomback AS, Stokes MB, Radhakrishnan J, D'Agati VD, Markowitz GS (2014) IgA nephropathy with minimal change disease. Clin J Am Soc Nephrol 9:1033–1039. https://doi.org/10.2215/CJN.11951113CrossRefPubMedPubMedCentral

41.

Sinnassamy P, O'Regan S (1985) Mesangial IgA deposits with steroid responsive nephrotic syndrome: probable minimal lesion nephrosis. Am J Kidney Dis 5:267–269CrossRef

42.

Saint-André JP, Simard C, Spiesser R, Houssin A (1980) Nephrotic syndrome in a child, with minimal glomerular lesions and mesangial IgA deposits. Nouv Press Med 9:531–532

43.

(1985) Association of IgA nephropathy with steroid-responsive nephrotic syndrome. A report of the Southwest Pediatric Nephrology Study Group. Am J Kidney Dis 5:157–164

44.

Floege J, Amann K (2016) Primary glomerulonephritides. Lancet 387:2036–2048. https://doi.org/10.1016/S0140-6736(16)00272-5CrossRefPubMed

45.

Eddy AA, Symons JM (2003) Nephrotic syndrome in childhood. Lancet 362:629–639. https://doi.org/10.1016/S0140-6736(03)14184-0CrossRefPubMed

46.

Cattran DC, Feehally J, Cook HT, Liu ZH, Fervenza FC, Mezzano SA, Floege J, Nachman PH, Gipson DS, Praga M (2012) Kidney disease: improving global outcomes (KDIGO) glomerulonephritis work group. KDIGO clinical practice guideline for glomerulonephritis. Kidney Int Suppl 2:139–274CrossRef

47.

Niaudet P, Murcia I, Beaufils H, Broyer M, Habib R (1993) Primary IgA nephropathies in children: prognosis and treatment. Adv Nephrol Necker Hosp 22:121–140PubMed

48.

Kawasaki Y, Maeda R, Kanno S, Suzuki Y, Ohara S, Suyama K, Hosoya M (2017) Long-term follow up of pediatric immunoglobulin A nephropathy treated with tonsillectomy plus methylprednisolone pulse therapy. Pediatr Int 59:41–47. https://doi.org/10.1111/ped.13074CrossRefPubMed

49.

Welch TR, McAdams AJ, Berry A (1988) Rapidly progressive IgA nephropathy. Am J Dis Child 142:789–793PubMed

50.

Itami N, Akutsu Y, Kusunoki Y, Tochimaru H, Takekashi Y (1989) Does methylprednisolone pulse therapy deteriorate the course of rapidly progressive IgA nephropathy? Am J Dis Child 143:441–442PubMed

51.

Piñeiro GJ, Arrizabalaga P, Solé M, Abellana RM, Espinosa G, Cervera R (2016) Repeated renal biopsy—a predictive tool to assess the probability of renal flare in lupus nephritis. Am J Nephrol 44:439–446. https://doi.org/10.1159/000452229CrossRefPubMed

52.

Yoshikawa N, Iijima K, Matsuyama S, Suzuki J, Kameda A, Okada S, Nakamura H (1990) Repeat renal biopsy in children with IgA nephropathy. Clin Nephrol 33:160–167PubMed

53.

Luo MN, Yao CW, Xu BH, Xu YZ, Liu WJ, Feng YM, Tao JL, Liu HF (2014) Continuation of immunosuppressive treatment may be necessary in IgA nephropathy patients with remission of proteinuria: evaluation by repeat renal biopsy. Exp Ther Med 7:553–559. https://doi.org/10.3892/etm.2013.1467CrossRefPubMed

54.

Tøndel C, Vikse BE, Bostad L, Svarstad E (2012) Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010. Clin J Am Soc Nephrol 7:1591–1597. https://doi.org/10.2215/CJN.02150212CrossRefPubMedPubMedCentral

55.

Shen XH, Liang SS, Chen HM, Le WB, Jiang S, Zeng CH, Zhou ML, Zhang HT, Liu ZH (2015) Reversal of active glomerular lesions after immunosuppressive therapy in patients with IgA nephropathy: a repeat-biopsy based observation. J Nephrol 28:441–449. https://doi.org/10.1007/s40620-014-0165-xCrossRefPubMed

56.

Berg UB, Bohman SO, Widstam-Attorps U (1991) Renal histological changes in relation to renal function and urinary protein excretion in IgA nephropathy. Arch Dis Child 66:593–597CrossRef

57.

El Karoui K, Hill GS, Karras A, Moulonguet L, Caudwell V, Loupy A, Bruneval P, Jacquot C, Nochy D (2011) Focal segmental glomerulosclerosis plays a major role in the progression of IgA nephropathy. II. Light microscopic and clinical studies. Kidney Int 79:643–654. https://doi.org/10.1038/ki.2010.460CrossRefPubMed

58.

Bellur SS, Lepeytre F, Vorobyeva O, Troyanov S, Cook HT, Roberts IS, International IgA Nephropathy Working Group (2016) Evidence from the Oxford classification cohort supports the clinical value of subclassification of focal segmental glomerulosclerosis in IgA nephropathy. Kidney Int 91:235–243. https://doi.org/10.1016/j.kint.2016.09.029CrossRefPubMed

59.

Kuppe C, Gröne HJ, Ostendorf T, van Kuppevelt TH, Boor P, Floege J, Smeets B, Moeller MJ (2015) Common histological patterns in glomerular epithelial cells in secondary focal segmental glomerulosclerosis. Kidney Int 88:990–998. https://doi.org/10.1038/ki.2015.116CrossRefPubMed

Titel: Steroid therapy in children with IgA nephropathy
verfasst von: Alexandra Cambier
Olivia Boyer
Georges Deschenes
James Gleeson
Anne Couderc
Julien Hogan
Thomas Robert
Publikationsdatum: 18.02.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 3/2020
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-4189-7

Neu im Fachgebiet Pädiatrie

23.04.2024 | Typ-1-Diabetes | Nachrichten

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Steroid therapy in children with IgA nephropathy

Abstract

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2020

Rare cause of severe hypertension in an adolescent boy presenting with short stature: Answers

Treatment of hyperphosphatemia: the dangers of aiming for normal PTH levels

Long-lasting chronic high load carriage of Epstein-Barr virus is more common in young pediatric renal transplant recipients

A cross-sectional study on uric acid levels among Chinese adolescents

Energy and protein requirements for children with CKD stages 2-5 and on dialysis–clinical practice recommendations from the Pediatric Renal Nutrition Taskforce

Diagnostics, treatment, and immune response in BK polyomavirus infection after pediatric kidney transplantation

Neu im Fachgebiet Pädiatrie

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Pädiatrie