Abstract: FR-PO0713
Significance of Persistent Hematuria in Childhood IgAN
Session Information
- Pediatric Nephrology: CKD, ESKD, and Glomerular Diseases
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Shima, Yuko, Wakayama Kenritsu Ika Daigaku, Wakayama, Wakayama Prefecture, Japan
- Mukaiyama, Hironobu, Wakayama Kenritsu Ika Daigaku, Wakayama, Wakayama Prefecture, Japan
- Tanaka, Yu, Wakayama Kenritsu Ika Daigaku, Wakayama, Wakayama Prefecture, Japan
- Shimabukuro, Wataru, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Ginowan, Okinawa, Japan
- Kaito, Hiroshi, Hyogo Kenritsu Kodomo Byoin, Kobe, Hyogo Prefecture, Japan
- Tanaka, Ryojiro, Hyogo Kenritsu Kodomo Byoin, Kobe, Hyogo Prefecture, Japan
- Nozu, Kandai, Kobe Daigaku, Kobe, Hyogo Prefecture, Japan
- Iijima, Kazumoto, Kobe Daigaku, Kobe, Hyogo Prefecture, Japan
- Tokuhara, Daisuke, Wakayama Kenritsu Ika Daigaku, Wakayama, Wakayama Prefecture, Japan
- Yoshikawa, Norishige, Takatsuki Byoin, Takatsuki, Osaka Prefecture, Japan
- Nakanishi, Koichi, Ryukyu Daigaku Igakubu Daigakuin Igaku Kenkyuka, Ginowan, Okinawa, Japan
Background
While proteinuria remission is the most significant predictive for kidney outcome in childhood IgA nephropathy (c-IgAN), the value of persistent hematuria in predicting outcomes in c-IgAN is still debated. The purpose of this study is to clarify the clinicopathological significance and determinants of persistent hematuria (red blood cell count ≥ 5 HPF).
Methods
From July 1976 to December 2022, there were 567 children with biopsy-proven IgAN at Kobe University and Wakayama Medical University. We investigated clinicopathological differences in 263 (46.4%) with hematuria remission and 304 (53.6%) with persistent hematuria.
Results
The c-IgAN patients with persistent hematuria were more detected by school screening program (82.6 vs.75.3%, p=.04), higher onset age (11.8 vs. 10.1 yrs, p<.0001), and showed longer duration from onset to kidney biopsy (9.3 vs. 6.3 months, p=.02), lower rate of proteinuria remission (14.8 vs. 86.3%, p<.0001), and shorter observation period (3 vs. 8 yrs, p<.0001). There was no significant difference in pathological findings and treatments. The kidney survival rate of persistent hematuria group was significantly lower than that of hematuria remission group (67.2 [95%CI: 41.4-85.6] vs. 98.7 [95%CI: 96.0-99.6] % at 15 years, p<.0001). The Cox regression analyses showed that both proteinuria remission (HR: 0.04 [95%CI: 0.005-0.29], p=.0015) and hematuria remission (HR:0.06 [95%CI: 0.05-0.28], p=.0003) were significantly related to kidney outcome respectively in univariate analyses, but that only proteinuria remission was significantly related (HR:0.10 [95%CI: 0.01-1.00], p=0.02) in multivariate analyses.
Conclusion
Regarding kidney outcome, proteinuria remission is more important than disappearance of hematuria.