Nefropatía por Ig A en pediatría, desenlaces clínicos con diferentes esquemas de manejo.

Introduction: IgA nephropathy (IgAN) is the most common glomerular disease in the world, in Colombia belongs to 11-22% of primary glomerulonephritis in pediatric patients. Of these, 30% progress to chronic kidney disease.   Materials and methods: It is a retrospective descriptive study. We used median and IRQ for continuous variables, and proportions for categorical variables, Fisher test to compare clinical outcomes.   Results: Between 1996 to 2013 58 patients were diagnosed. The mean age at symptoms onset was 7.5 years (SD±4.2) and at the time of renal biopsy was 10 years (SD±3.8). At diagnosis, 77.6% of the patients showed microscopic hematuria, 27.6% gross hematuria and 81% proteinuria, classified as severe in 29%. Three patients required dialysis and two needed kidney transplant. Three groups with different therapeutic regimens were evaluated: first group only prednisone 34.5% (n = 20), second group prednisone and mycophenolate mofetil (MMF) 22.4% (n = 13) and third group without prednisone neither MMF 43.1% (n = 25). The difference in the presence of hematuria among the groups was significant (p> 0.001), being more frequent in the group without prednisone neither MMF (68%). There were no significant differences in proteinuria, hypertension or creatinine among the groups. The median of years between the renal biopsy and the last control was 4 years RI 1-7. At five years, the renal fuction survival probability (GFR >90 ml/min/1.73m2) was 89.1%.   Conclusion: IgAN needs early recognition and strict follow-up, since it may have ominous outcomes. The results of the present work constitute up to now the most extensive experience described in the Colombian pediatric population.