Abstract
BackgroundThe clinical presentation of Henoch–Schönlein purpura nephritis (HSPN) has not been thoroughly investigated among patients of different ages. We therefore compared the features of HSPN and IgA nephropathy (IgAN) based on data from the Japan Renal Biopsy Registry (J-RBR).MethodsThis cross-sectional study analyzed data from patients who were registered in the J-RBR between 2007 and 2012. Clinico-pathological findings at diagnosis were compared among children (aged ≤18 years), adult (aged 19–64 years) and elderly (aged ≥65 years) patients with HSPN (n = 513) and IgAN (n = 5679).ResultsThe age at diagnosis considerably differed between HSPN and IgAN; HSPN peaked at 1–19 and at 60–69 years, whereas IgAN peaked at 30–39 years. The clinical features were significantly more severe for HSPN than IgAN, especially proteinuria (children, 1.28 vs. 0.57; adult, 1.95 vs. 1.05; elderly patients, 2.71 vs. 1.64 g/day), and low albumin levels (children, 3.72 vs. 4.13; adults, 3.62 vs. 3.99; elderly patients, 3.07 vs. 3.57 g/dL). The rate (%) of histologically classified endocapillary proliferative or crescentic glomerulonephritis was higher in patients with HSPN than with IgAN. Multiple regression analysis revealed that low albumin level and high BP were independent factors associated with decreased estimated glomerular filtration rates in adult and elderly patients with HSPN.ConclusionsAge at HSPN diagnosis was bimodally distributed, and the clinical features of HSPN were more severe than those of IgAN across all age groups.
Highlights
Immunoglobulin A nephropathy (IgAN) is one of the most prevalent types of glomerulonephritis, especially in East Asia, Europe, and North America [1,2,3]
Clinical parameters were compared between the groups with Henoch– Schonlein purpura nephritis (HSPN) and IgA nephropathy (IgAN) using the unpaired t test for normally distributed continuous variables or the Mann–Whitney U test for non-normally distributed continuous variables
The present study of the Japan Renal Biopsy Registry (J-RBR) revealed that the distribution of age at HSPN diagnosis was bimodal with peaks at 1–19 and 60–69 years, whereas that at IgAN diagnosis peaked during the fourth decade
Summary
Immunoglobulin A nephropathy (IgAN) is one of the most prevalent types of glomerulonephritis, especially in East Asia, Europe, and North America [1,2,3]. Some studies have compared the clinical and pathological findings between IgAN and HSPN [18, 19]. These studies included relatively few participants with age restrictions, and the clinical presentation of HSPN has not been thoroughly assessed in an adequate sample of patients at different ages. We compared the features of HSPN and IgA nephropathy (IgAN) based on data from the Japan Renal Biopsy Registry (J-RBR). Methods This cross-sectional study analyzed data from patients who were registered in the J-RBR between 2007 and 2012.
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