EFFECT OF INTRAUTERINE GROWTH-RETARDATION ON THE CLINICAL COURSE AND PROGNOSIS OF IGA GLOMERULONEPHRITIS IN CHILDREN

Intrauterine growth retardation (IUGR) resulting in a reduced number o f nephrons is one of the nonimmune mechanisms that have been recently proposed as contributing to the progression of renal diseases. The pur pose of our study was to determine whether IUGR has any effect on the clinical course and prognosis of IgA glomerulonephritis (IgA GN) in ch ildren. Fifty children with biopsy-proven IgA GN, who were followed fo r at least 3 years, were included. Six of the 50 children (12%) had si gns of IUGR at birth, defined as birth weight below the 10th percentil e for gestational age. There were no significant differences in initia l clinical presentation between children with IUGR and those without I UGR. However, in kidney biopsy specimens, we found a significantly hig her mean percentage of sclerotic glomeruli in children with IUGR than in those without IUGR (33 vs. 13%, p < 0.015). At the end of the follo w-up period, we observed a significantly higher incidence of arterial hypertension in children with IUGR than in those without IUGR (50 vs. 11%, p < 0.05). Other differences between the two groups of children w ere not statistically significant. In conclusion, our study demonstrat ed an increased risk of the development of arterial hypertension and g lomerulosclerosis in children with IgA GN who had suffered from IUGR w ith a birth weight below the 10th percentile for gestational age. IUGR may therefore help to identify early in the course of IgA GN those ch ildren who are at higher risk of an unfavorable course.