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Al Zahrani RA. Histological Features of IgA Nephropathy in Pediatrics and the Magnitude of the Disease in Saudi Children. Int J Pediatr 2023; 2023:3466726. [PMID: 37050917 PMCID: PMC10085659 DOI: 10.1155/2023/3466726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 04/14/2023] Open
Abstract
Objectives This review addresses the microscopic features of immunoglobulin A nephropathy (IgA nephropathy), its prognostic variables in children, and measures to which extent these features and variables differ from adults. Furthermore, it describes the extent of this disease process among children in Saudi Arabia and the rest of the Arab countries and compares it with the data from the West and the Far East. Method All the original work described the histological features of pediatric IgA nephropathy, and studies involved in developing the prognostic classification of IgA nephropathy, Oxford Classification, were reviewed. Moreover, the studies describing the crescent prevalence and outcome in pediatric IgA nephropathy in addition to thrombotic microangiopathy association were studied. National studies describing the prevalence of pediatric IgA nephropathy and pediatric crescentic glomerulonephritis were tracked with an overview of the regional data from the rest of the Arab world. Results IgA nephropathy in children showed more glomerular proliferative changes and less glomerular vascular and tubule-interstitial chronic injury compared to adults. The reference study that described the association between thrombotic microangiopathy and IgA nephropathy did not include the pediatric age group. Moreover, it was found that the data from the Middle East was not encountered in developing the original and updated IgA nephropathy Oxford Classification. Furthermore, the prevalence of IgA nephropathy in children is described in the regional literature, but its histological features were not well detailed. Finally, the percentage of crescentic glomerulonephritis (GN) due to IgA nephropathy is less in our country compared to the West and concords with the Far East findings. Conclusion A well-designed regional study addressing IgA nephropathy in Middle East children with a focus on histological features, association with crescent, and thrombotic microangiopathy and challenging the validity of the updated IgA nephropathy Oxford Classification is recommended.
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Affiliation(s)
- Reem A. Al Zahrani
- Faculty of Medicine, Department of Pathology, King Abdulaziz University and King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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He G, Tao L, Li C, Zhong X, Wang H, Ding J. The spectrum and changes of biopsy-proven kidney diseases in Chinese children. J Nephrol 2023; 36:417-427. [PMID: 36472788 DOI: 10.1007/s40620-022-01527-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022]
Abstract
AIM The study aimed to investigate the spectrum of biopsy-proven kidney disease in Chinese children. METHODS Records of children 0-17 years old who underwent native kidney biopsy from June 1st, 2013 to December 31st, 2018 in the national inpatients' database of China were analyzed. Biopsy-proven kidney diseases of different sex, age groups, and diagnosis, and the changing patterns of kidney disease compared with the previous study were analyzed. RESULTS A total of 21,311 patients from 232 hospitals with a median age of 11.34 years were included. Immunoglobulin A vasculitis with nephritis (IgAVN) was the most common pathological finding [29.17%, 95% confidence interval (confidence interval, CI) = 28.56-29.78], followed by IgA nephropathy (IgAN) (22.70%, 95% CI = 22.14-23.27). IgAN was the most common finding in patients with hematuria (60.75%, 95% CI = 58.83-62.65], proteinuria (33.43%, 95% CI = 30.54-36.42), and hematuria plus proteinuria (62.77%, 95% CI = 56.19-69.02). Minimal change disease was the most common finding (40.69%, 95% CI = 39.41-41.98) in nephrotic syndrome. The proportion of IgAVN in patients with biopsy-proven glomerular disease increased year by year during 2013-2018 (p for trend < 0.001) and was higher than that of 2004-2014 [29.41% (95% CI = 29.10-29.72) in 2013-2018 vs. 13.35% (95% CI = 12.97-13.73) 2004-2014, p < 0.001]. The proportion of hepatitis B virus associated nephritis during 2013-2018 was lower than that of 2004-2014 [0.44% (95% CI = 0.36-0.54) in 2013-2018 vs. 0.87% (95% CI = 0.67-1.10) in 2004-2014, p < 0.001]. CONCLUSIONS IgAVN and IgAN were the most common types of pathological findings in children who underwent kidney biopsies from 2013 to 2018. The pathological spectrum of kidney biopsy changed over time.
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Affiliation(s)
- Guohua He
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Xuhui Zhong
- Department of Pediatrics, Peking University First Hospital, Beijing, China
| | - Haibo Wang
- Clinical Trial Unit, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jie Ding
- Department of Pediatrics, Peking University First Hospital, Beijing, China.
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Kidney disease profile and encountered problems during follow-up in Syrian refugee children: a multicenter retrospective study. Pediatr Nephrol 2022; 37:393-402. [PMID: 34331573 DOI: 10.1007/s00467-021-05046-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/09/2021] [Accepted: 03/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Children are one of the most vulnerable groups in conflict zones, especially those with chronic diseases. This study aimed to investigate kidney disease profiles and problems during follow-up in a population of Syrian refugee children residing in Turkey. METHODS Syrian refugee children aged between 0 and 18 years were included in the study. Demographic data, diagnosis, particular interventions due to nephrological problems, and problems encountered during follow-up were obtained from all participating pediatric nephrology centers. RESULTS Data from 633 children from 22 pediatric nephrology centers were included. Mean age of the children was 94.8 ± 61.7 months and 375 were male (59%). 57.7% had parental consanguinity and 23.3% had a close relative(s) with kidney disease. The most common kidney diseases were congenital anomalies of the kidney and urinary tract (CAKUT) (31.0%), glomerular disease (19.9%), chronic kidney disease (CKD) (14.8%), and urolithiasis (10.7%). Frequent reasons for CAKUT were nonobstructive hydronephrosis (23.0%), vesico-ureteral reflux (18.4%), and neurogenic bladder (15.8%). The most common etiology of glomerular diseases was nephrotic syndrome (69%). Ninety-four children had CKD, and 58 children were on chronic dialysis. Six children had kidney transplantation. Surgical intervention was performed on 111 patients. The language barrier, lack of medical records, and frequent disruptions in periodic follow-ups were the main problems noted. CONCLUSIONS CAKUT, glomerular disease, and CKD were highly prevalent in Syrian refugee children. Knowing the frequency of chronic diseases and the problems encountered in refugees would facilitate better treatment options and preventive measures.
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Alhasan KA, Al Khalifah R, Aloufi M, Almaiman W, Hamad M, Abdulmajeed N, Al Salloum A, Kari JA, AlJelaify M, Bassrawi RK, Al Hussain T, Alherbish A, Al Talhi A, Temsah MH, Sethi SK, Raina R, Joseph R, Amer YS. AGREEing on clinical practice guidelines for idiopathic steroid-sensitive nephrotic syndrome in children. Syst Rev 2021; 10:144. [PMID: 33971949 PMCID: PMC8112064 DOI: 10.1186/s13643-021-01666-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nephrotic syndrome is the most common kidney disease in children worldwide. Our aim was to critically appraise the quality of recent Clinical Practice Guidelines (CPGs) for idiopathic steroid-sensitive nephrotic syndrome (SSNS) in children in addition to summarize and compare their recommendations. METHODS Systematic review of CPGs. We identified clinical questions and eligibility criteria and searched and screened for CPGs using bibliographic and CPG databases. Each included CPG was assessed by four independent appraisers using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) instrument. We summarized the recommendations in a comparison practical table. RESULTS Our search retrieved 282 citations, of which three CPGs were eligible and appraised: Kidney Disease: Improving Global Outcomes (KDIGO) 2012, Japan Society for Pediatric Nephrology (JSPN) 2014, and American Academy of Pediatrics (AAP) 2009. Among these, the overall assessment of two evidence-based CPGs scored > 70% (KDIGO and JSPN), which was consistent with their higher scores in the six domains of the AGREE II Instrument. In domain 3 (rigor of development), KDIGO, JSPN, and AAP scored 84%, 74%, and 41%, respectively. In domain 5 (applicability), they scored 22%, 16%, and 19%, respectively, and in domain 6 (editorial independence), they scored 94%, 65%, and 88%, respectively. CONCLUSIONS The methodological quality of the KDIGO CPG was superior, followed by JSPN and AAP CPGs with the relevant recommendations for use in practice. SYSTEMATIC REVIEW REGISTRATION The protocol was registered in the Center for Open Science (OSF) DOI: 10.17605/OSF.IO/6QTMD and in the International prospective register of systematic reviews PROSPERO 2020 CRD42020197511 .
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Affiliation(s)
- Khalid Abdulaziz Alhasan
- Pediatric Nephrology Unit, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Saudi Society of Nephrology and Transplantation (SSN&T), Riyadh, Saudi Arabia
| | - Reem Al Khalifah
- Pediatric Endocrinology Unit, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Majed Aloufi
- Department of Pediatric Nephrology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Weiam Almaiman
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Nephrology Section, Pediatrics Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Muddathir Hamad
- Pediatric Neurology Unit, Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | | | - Abdullah Al Salloum
- Pediatric Nephrology Unit, Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Jameela A Kari
- Pediatric Nephrology Division, Department of Pediatrics, Pediatric Nephrology Center of Excellence Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muneera AlJelaify
- Pharmacy Services Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Rolan K Bassrawi
- General Pediatrics Unit, Pediatrics Department, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Turki Al Hussain
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.,Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Adi Alherbish
- Pediatrics Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulhadi Al Talhi
- Department of Pediatric Nephrology, Pediatrics Hospital, King Saud Medical City, Riyadh, Saudi Arabia.,Imam Mohammed Bin Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Rupesh Raina
- Pediatric Nephrology, Akron Children's Hospital, Akron, OH, USA
| | - Reny Joseph
- Ward 11B and Day Care, Pediatrics-Nursing, King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Yasser Sami Amer
- Pediatrics Department, King Khalid University Hospital, Riyadh, Saudi Arabia. .,Clinical Practice Guidelines Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia. .,Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia. .,Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria, Egypt.
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