Prognosis factors of Henoch-Schonlein purpura nephritis in children

Abstract

Objective To investigate the outcome predictors of renal injury in children with Henoch-Schonlein purpura nephritis(HSPN). Methods One hundred and thirty-seven patients with HSPN, who were admitted to Shanghai Children′s Hospital from January 2009 to December 2013, were retrospectively studied. The data of gender, age, clinical features, and pathological changes were collected. Results (1) Among the 137 children, whose median duration of follow-up was (43.10±16.39)months, 99 cases (72.26%) had good outcomes(grade A), 36 cases (26.28%) had grade B, only 2 cases without remission(grade C), and no cases progressed to renal failure(grade D). (2)Patients had relatively poor prognosis if they were presented with the higher urine protein, blood urea nitrogen(BUN), serum creatinine(Cr), cystatin C(Cys-C), IgA, thrombin time(TT), and the lower glomerular filtration rate (GFR). (3)The most common clinical types of HSPN were hematuria and proteinuria (111/137 cases, 81.02%), and 80 cases of them (72.07%) achieved grade A, and only 1 case (0.90%)got grade C. Only 1 case whose clinical ma-nifestations was acute nephritis got grade C. Clinical manifestations were associated with prognosis of HSPN(P 0.05). Conclusions The prognosis of HSPN is associated with clinical classification, pathological stage. Moreover, the prognosis predictors include elevated urine protein, BUN, Cr, Cys-C, IgA, TT, and decreased GFR.Optimistic prognosis could be generated from timely and early treatment. Key words: Henoch-Schonlein purpura nephritis; Clinical features; Pathological grade; Prognosis; Retrospective analysis