2009 Volume 22 Issue 1 Pages 41-45
We report a pediatric case of severe IgA nephropathy who showed rapid progression to end-stage renal failure. Since age 11 years, the patient was detected to have proteinuria and hematuria by a school urinary screening (SUS) system. However, she did not visit any clinics for further examinations. Two years later, she visited a pediatric clinic with complaints of prominent edema and oliguria. At the first visit to our hospital, the patient showed severe hypertension and renal dysfunction with massive proteinuria. Renal biopsy showed IgA nephropathy with significant numbers of sclerotic glomeruli and severe tubulointerstitial damage. Within 3 months since the first visit to us, the patient progressed to end-stage renal failure. Renal transplantation was performed following short-term dialysis. To achieve better performance of Japanese SUS system and to reduce patients with chronic kidney disease, care should be taken that further investigation will be carried out.
