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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
IgA nephropathy (IgAN) is a rare condition with limited randomized controlled trials in children. As a result, treatment in children primarily relies on adult data. Historically, children were treated with the Pozzi Protocol (4-6 months of glucocorticoids [steroids]) based on an adult study (1999). However, applying adult data to children is not ideal because pharmacokinetics and pharmacodynamics may influence how children respond. Additionally, children are vulnerable to adverse drug events (ADEs) from steroids, especially during puberty. This study aimed to describe kidney outcomes and ADEs in children with IgAN treated with steroids.
This descriptive, retrospective population-based study included children (<18 years) diagnosed with IgAN between 2010 and 2022 in Calgary, Canada. Kidney transplants at baseline and a co-diagnosis of minimal change disease were excluded. The cohort was identified from the biopsy registry, and data were extracted from electronic medical records after a waiver of consent. Outcomes were (1) annual changes in estimated glomerular filtration rate (eGFR) and proteinuria (urine protein to creatinine ratio or uPCR), (2) clinical remission, and (3) ADEs. Descriptive statistics were used to report baseline characteristics, treatment and outcomes. No comparative analysis was done due to the small sample size and high selection bias.
The cohort included 58 children, with a median age of 13.8 years (10.9-15.3) at presentation and 14 years (11.1-15.7) at diagnosis. Majority (60.3%) were males. Twenty-six children (44.8%) received Pozzi protocol after a kidney biopsy and within 6 months of diagnosis (treated group). The treated group had more severe disease at baseline, with lower eGFR (93 versus 105 ml/min/1.73m2) and higher proteinuria (uPCR: 278 versus 63 mg/mmol). Annual eGFR change was similar in both groups (-4.1 ml/min/1.73m2). Annual proteinuria change was higher in the treated group (-37.3 [-110.6 to -9.5] mg/mmol) compared with the untreated group (-8.9 [-19.8 to -0.6] mg/mmol), likely due to higher baseline proteinuria in the treated group. Thirty children (51.8%) achieved clinical remission and were less likely to be treated with steroids (33.3% versus 66.7%).
ADEs were not systematically assessed and documented. Of those treated with steroids, 68.6% had an ADE, with 2.6 events per person. The cumulative steroid dose was higher in the ADE group (231 mg/kg versus 176 mg/kg).
The most common ADE was excessive weight gain (48.6%) with a median weight gain of 7.5 (6-9) kg within 6 months of starting steroids. Children with excessive weight gain were more likely to be obese at study exit (median weight of 91 kg, seven years of follow-up). Other ADEs included skin toxicity (37.1%), hypertension (20%), neuropsychiatric effects (14.3%), and gastritis (5.7%). One patient had severe ADEs with 7 events, including sepsis, myopathy and severe obesity.
Harmful effects of glucocorticoid therapy in children with IgAN, especially the long-term consequences of obesity, should be considered. Routine assessment of steroid toxicity in children and low-dose steroid protocols should be implemented. Further, clinical trials in children are needed to identify safe and effective treatments.
