Scholarlink

Background <p>Red blood cell casts (RBCC) on kidney biopsy are linked to favorable renal outcomes in adult IgA nephropathy (IgAN), but their role in pediatric IgAN is unclear. This study examined the prevalence and prognostic value of RBCC in children.</p> Methods <p>This retrospective cohort study analyzed 1283 pediatric patients (≤ 18&#xa0;years) with biopsy-proven IgAN from Jinling Hospital (2000–2020), with a median follow-up of 122&#xa0;months. The association between RBCC and a composite kidney endpoint (sustained 30% eGFR decline, kidney failure, or kidney-related death) was assessed.</p> Results <p>RBCC were present in 13.5% of patients. RBCC positivity was associated with active clinical signs (e.g., gross hematuria) yet a significantly lower risk of the composite endpoint (adjusted HR 0.51, 95% CI 0.32–0.85). This protective effect was strongest in patients with preserved kidney function (eGFR ≥ 60&#xa0;ml/min/1.73 m<sup>2</sup>; HR 0.14) and no tubular atrophy (T0 lesions). The association was weaker in patients with reduced eGFR and not significant in those receiving immunosuppressive therapy.</p> Conclusions <p>In pediatric IgAN, RBCC were associated with an active clinical presentation but a more favorable long-term renal prognosis, particularly in patients with early-stage disease. This suggests RBCC may serve as a useful prognostic marker in this population.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Red blood cell casts on kidney biopsy and progression of IgA nephropathy in children

  • 期刊论文

  • 发表日期：

    2026年6月1日

查看全文
  • Heyan Wu,
  • Zidong Huang,
  • Zhengkun Xia,
  • Lidan Zhang

摘要

Background

Red blood cell casts (RBCC) on kidney biopsy are linked to favorable renal outcomes in adult IgA nephropathy (IgAN), but their role in pediatric IgAN is unclear. This study examined the prevalence and prognostic value of RBCC in children.

Methods

This retrospective cohort study analyzed 1283 pediatric patients (≤ 18 years) with biopsy-proven IgAN from Jinling Hospital (2000–2020), with a median follow-up of 122 months. The association between RBCC and a composite kidney endpoint (sustained 30% eGFR decline, kidney failure, or kidney-related death) was assessed.

Results

RBCC were present in 13.5% of patients. RBCC positivity was associated with active clinical signs (e.g., gross hematuria) yet a significantly lower risk of the composite endpoint (adjusted HR 0.51, 95% CI 0.32–0.85). This protective effect was strongest in patients with preserved kidney function (eGFR ≥ 60 ml/min/1.73 m2; HR 0.14) and no tubular atrophy (T0 lesions). The association was weaker in patients with reduced eGFR and not significant in those receiving immunosuppressive therapy.

Conclusions

In pediatric IgAN, RBCC were associated with an active clinical presentation but a more favorable long-term renal prognosis, particularly in patients with early-stage disease. This suggests RBCC may serve as a useful prognostic marker in this population.

Graphical abstract