Preventive effect of heparin on the development of nephropathy in Henoch-Schoenlein purpura-a randomized controlled clinical trial

Abstract

Objective To evaluate the preventive value of heparin on the development of nephropathy in patients with Henoch-Schoenlein purpura (HSP). Methods Two-hundred and twenty-eight patients with HSP were enrolled in the study and divided randomly into two groups: heparin group (H) and control group (C). In H group, 119 patients were administrated with sodium heparin intravenously (120~150 IU/kg·d) for five days or with calcium heparin subcutaneously (20 IU/kg·d ) for seven days at the onset or relapse of HSP; whereas 109 patients as C group only received vehicles. All patients were also medicated with other commonly used drugs, such as vitamin C and vitamin P, and followed up for more than three months. Results The patient numbers of developing nephritis were nine (7.6%) in H group and 30 (27.5%) in C group, respectively (P<0.01). The occurrence of nephritis in H group was significantly delayed than that in C group [(82±64) day vs. (34±32) day, P<0.01]. The clinical characteristics of renal involvement in H and C groups consisted of 2 cases (22.2%) and 12 cases (40.0%) of simple hematuria, 6 cases (66.7%) and 15 cases (50.0%) of hematuria plus proteinuria, 1 case (11.1%) and 3 cases (10.0%) of hematuria plus nephrosis, respectively. There was no significant difference. No severe side effects, such as bleeding, were observed during the process of heparin treatment. Conclusion Heparin, which was safe and tolerant for patients, could significantly reduce the incidence of HSP nephritis (HSPN) and improve the prognosis of HSP. Key words: Purpura, schoenlein-henoch; Heparin; Nephritis; Randomized controlled trials