ArticlePediatric nephrology (Berlin, Germany)2026
Red blood cell casts on kidney biopsy and progression of IgA nephropathy in children.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRed 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.
methodsThis 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.
resultsRBCC 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 m
conclusionsIn 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.
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