New prognostic markers for IgA nephropathy in children.

Abstract

IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, with significant implications for adults and children. The disease progresses variably, from asymptomatic hematuria to severe glomerulonephritis, and around 10-20% of children diagnosed in childhood develop stage 5 chronic kidney disease (CKD 5) within 20 years. Identifying reliable prognostic markers is crucial for early intervention and long-term management. The International IgAN Prediction Tool combines clinical, laboratory, and histological data and has been adapted for pediatric use. It is highly accurate in predicting CKD 5. Markers such as the Oxford MEST-C score, proteinuria, eGFR, and blood pressure assist in risk stratification. Emerging biomarkers, including the IgA/C3 ratio, galactose-deficient IgA1, soluble CD89, and urinary cytokines like IL-6 and TGF-β1, show potential for predicting disease progression. Although promising, further research is needed to validate these biomarkers in pediatric populations and refine predictive tools for IgAN progression. These advances will guide targeted therapies and improve long-term renal outcomes in children.