Risk Factors For Renal Involvement Research Articles

Determinants and risk factors for renal damage: where do patients hospitalized for severe anorexia nervosa stand? A multi-center study

BackgroundAlthough renal damage is increasingly reported among the most undernourished patients with Anorexia Nervosa (AN), it remains underestimated in current practice, and often associated with acute dehydration. The purpose of our study was to evaluate the frequency, the extent, and the risk factors of renal involvement among adolescents and adults hospitalized in specialized units for AN.MethodsIn this multi-center study, 197 consecutive participants were included, aged 13–65, from 11 inpatient eating disorder psychiatric units. Information on the course of AN, clinical characteristics, biological data, and medication were collected.ResultsAt admission, mean BMI was 13.1 (± 1.6) kg/m2 for a mean age of 20.74 (± 6.5) years and the z-score was − 3.6 (± 1.33). Six participants (3.0%) had hyponatremia, four (2.0%) had hypokalemia, and nine (4.5%) had hypochloremia. The Blood Urea Nitrogen/Creatinine ratio was over 20 for 21 (10.6%) participants. The mean plasma creatinine was 65.22 (± 12.8) µmol/L, and the mean eGFR was 74.74 (± 18.9) ml/min. Thirty- five participants (17.8%) had an eGFR > 90 ml/min, 123 (62.4%) from 60 to 90 ml/min, 35 (17.8%) from 45 to 60 ml/min, and 4 (2%) under 45 ml/min. In multivariate analysis, only BMI on admission was a determinant of renal impairment. The lower the BMI the more severe was the renal impairment.ConclusionWhen eGFR is calculated, it highlights renal dysfunction found in severe AN requiring hospitalisation in specialized units. The severity of undernutrition is an independent associated factor. Kidney functionality tests using eGFR, in addition to creatinine alone, should be part of routine care for patients with AN to detect underlying renal dysfunction.

IgA Vasküliti (Henoch-Schönlein Purpurası) Olan Pediatrik Hastaların Epidemiyolojik, Klinik ve Laboratuvar Bulgularının Değerlendirilmesi

Objective: Immunoglobulin A vasculitis (Henoch-Schönlein Purpura) is the most common systemic vasculitis of childhood involving the skin, joints, gastrointestinal tract, and kidneys, and less frequently affects other systems. In this study, we aimed to evaluate the epidemiologic, clinical, and laboratory findings of pediatric patients with IgA vasculitis. Material and Methods: In this study, 366 patients diagnosed with IgA vasculitis (Henoch-Schönlein Purpura) in the pediatric nephrology clinic were retrospectively analyzed. Demographic characteristics, clinical findings, system involvement, and laboratory findings were recorded. Results: Of the patients in the study, 57.9% (212) were male and the male-to-female ratio was 1.37. The most common age group was found to be between 5-9 years of age. A statistically significant correlation existed between age and renal involvement (p<0.001). It was found that renal involvement increased with increasing age. Gastrointestinal system involvement was statistically significantly higher in the male gender (p=0.003). A statistically significant correlation existed between increased leukocyte counts, gastrointestinal system involvement, and renal involvement (p=0.001, p=0.009, respectively). Conclusion: Age and increased leukocyte count were found to be risk factors for renal involvement. Male gender and increased leukocyte count were found to be risk factors for gastrointestinal system involvement.

Time of Onset and Risk Factors of Renal Involvement in Children with Henoch-Schönlein Purpura: Retrospective Study.

Background: Henoch-Schönlein purpura (HSP) is a common systemic vasculitis in children, involving the skin, musculoskeletal system, gastrointestinal tract and kidneys. Some studies in children have shown possible risk factors linked with the development and severity of HSP Nephritis (HSPN). The aim of this study was to research predicting factors for the development of HSPN. Methods: We retrospectively evaluated 132 pediatric patients with HSP, according to EULAR/PRINTO/PRESS criteria. All patients were screened for HSPN by urinalysis. Finally, we compared demographic, clinical and laboratory data in HSP patients with and without nephritis. Results: The median age at HSP diagnosis [6.2 (2.6–17.5) vs. 5.5 (0.8–15.4) years, p = 0.03] and the incidence of abdominal pain (48 vs. 27%, p = 0.01) were significantly higher in HSPN patients. No differences were evidenced regarding gender, allergic diseases, skin recurrences, gastrointestinal involvement, musculoskeletal involvement, scrotal involvement, and laboratory data (white blood cell count, neutrophil count, lymphocyte count, platelet count, C-reactive protein, erythrocyte sedimentation rate, and blood concentration of IgA). Conclusions: The age at diagnosis and abdominal pain were independent risk factors for renal involvement in HSP patients. However, due to the retrospective nature of this study, further long-term and prospective studies will be necessary.

Analysis of age-based stratified renal involvement in Tianjin first batch of 430 patients with Omicron variant of novel coronavirus infection

To investigate the incidence and clinical characteristics of renal involvement with Omicron coronavirus infection in age-based stratified patients. The first batch of 430 convalescent patients with Omicron coronavirus treated in Tianjin First Central Hospital from January 21, 2022 to March 7, 2022 were enrolled in this study. The baseline information, vaccination status and laboratory examination information of patients were extracted in order to analyze the incidence of renal involvement in age-based stratified patients. Multivariate Logistic regression analysis was conducted to determine the risk factors of renal involvement in different age groups. Excluding those younger than 1 year old and those with a history of chronic kidney disease, a total of 421 patients were included. There were 184 males and 237 females with an average age of (36.65±21.28) years. The types of renal involvement included pathological tubular urine (28.9%), proteinuria (16.9%), renal hematuria (14.7%), a slight decrease of estimated glomerular filtration rate (eGFR, 9.3%), renal glycosuria (0.5%). According to their age, all patients were divided into three groups: 113 cases of ≤ 18 years old, 244 cases of 19-59 years old and 64 cases of ≥ 60 years old. Significant difference was founded in the incidence of renal involvement among the three groups. The incidence of proteinuria, pathological tubular urine and slight decline of eGFR in the ≥ 60 years old group were significantly higher than those in the ≤ 18 years old group [28.1% (18/64) vs. 8.0% (9/112), 42.2% (27/64) vs. 19.6% (22/112), 34.9% (22/63) vs. 6.2% (7/113), respectively, all P < 0.01]. The incidence of slight decline of eGFR was significantly higher than that in 19-59 years old group [34.9% (22/63) vs. 4.1% (10/243), P < 0.01]. Multivariate Logistic regression analysis showed that age was significantly correlated with renal involvement after adjusting for the baseline situation, serological indexes and Omicron infection related indexes [odds ratio (OR) = 1.059, 95% confidence interval (95%CI) was 1.021-1.097, P = 0.002]. Compared with the group ≤ 18 years old, the risk of renal involvement in the group ≥ 60 years old was significantly increased (OR = 26.245, 95%CI was 1.357-507.458, P = 0.031). Age ≥ 60 years old was an independent risk factor for renal involvement with Omicron coronavirus infection. Although a low incidence of severe cases in Tianjin first batch of 430 patients with Omicron coronavirus infection, there is still a high incidence of renal involvement. Advanced age is the risk factor of renal involvement. We should pay more attention to the renal involvement of elderly with Omicron coronavirus infection.

Renal Involvement in Pediatric Patients with COVID-19: An Up-to-date Review.

In pediatric patients, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has been mostly associated with mild symptoms. However, as in adults, renal involvement has been reported in children and adolescents with Coronavirus Disease 2019 (COVID-19). This review aimed to report data about renal involvement in pediatric COVID-19 patients. The focuses were on the pathophysiology of acute kidney injury in Pediatric Inflammatory Multisystem Syndrome Temporally Associated (PIMS-TS) with SARS-CoV-2 and the possible impact of SARS-CoV-2 infection upon kidney function, as well as data concerning patients with previous kidney diseases, including Nephrotic Syndrome and Chronic Renal Disease. The implications for COVID-19 outcomes in pediatric patients were also discussed. This integrative review searched for articles on renal involvement in pediatric COVID-19 patients. The databases evaluated were PubMed and Scopus. The emergence of PIMS-TS with SARS-CoV-2 has shown that pediatric patients are at risk of severe COVID-19, with multi-organ involvement and dysfunction. In addition to intense inflammation, several systems are affected in this syndrome, collectively creating a combination of factors that results in acute kidney injury. Several studies have proposed that kidney cells, including the podocytes, might be at risk of direct infection by SARS-CoV-2, as high levels of ACE2, the virus receptor, are expressed on the membrane of such cells. Some cases of glomerular diseases triggered by SARS-CoV-2 infection and relapses of previous renal diseases have been reported. Further studies are necessary to establish risk factors for renal involvement in pediatric COVID-19 and to predict disease outcomes.

POS-121 RENAL FEATURES AND LESIONS OF SICKLE CELL DISEASE (SCD)

Sickle cell disease (SCD) is a common cause of hemolytic anemia and it is an increasing cause of chronic kidney disease. We aim to determine risk factors of renal involvement and different types of renal lesions in patients with SCD.

Risk factors for renal involvement in Henoch–Schönlein purpura

ObjectiveHenoch–Schönlein purpura is a systemic vasculitis that mainly occurs in children. Renal impairment is a major complication of Henoch–Schönlein purpura, but there is no established predictive marker for renal involvement. Thus, in this study, we investigated the risk factors for renal involvement in children with Henoch–Schönlein purpura. MethodThe medical records of children newly diagnosed as having Henoch–Schönlein purpura between 2005 and 2020 were reviewed retrospectively. Selected laboratory data were recorded before treatment initiation. The date and the age at diagnosis; sex; and the presence of arthralgia, gastrointestinal and renal involvement were obtained retrospectively. ResultsThis study included a total of 186 patients with Henoch–Schönlein purpura. Among them, 36.0% had renal involvement; 28.4% had only microscopic hematuria, 53.7% had non-nephrotic range proteinuria, and 17.9% had nephrotic-range proteinuria during follow-up. The mean age was higher (p = 0.016) and female sex was predominant (p = 0.001) in patients with renal involvement than in those without renal involvement. Blood neutrophil/lymphocyte ratio (p = 0.002) and platelet/lymphocyte ratio (p = 0.002) were significantly higher than that of the patients without renal involvement. No statistically significant differences were observed in the hemoglobin concentration, platelet count, presence of arthralgia, and gastrointestinal involvement between patients with and without renal involvement. Logistic regression analysis revealed female sex (odd ratio = 3.213) and neutrophil/lymphocyte ratio (odd ratio = 1.329) as risk factors for renal involvement. ConclusionsFemale sex and high neutrophil/lymphocyte ratio were risk factors for renal involvement in Henoch–Schönlein purpura.

Risk Factors Associated With Renal Involvement in Childhood Henoch-schonlein Purpura

Context: Henoch-Schonlein purpura (HSP) is a significant cause of chronic renal disease in children. This review determines some risk factors associated with renal involvement in childhood HSP. Evidence Acquisition: Electronic databases, including Google Scholar, PubMed, and Scopus were searched using the following keywords: “children”, “Henoch-Schonlein”, “risk factor”, “renal involvement”, and “IgA vasculitis”. This review was designed to identify the relevant electronic studies published in the English language from December 1998 to August 2018. Results: This review revealed that clinically older age at presentation, persistent rash, atypical rash, rash on unusual location, and gastrointestinal bleeding were significant risk factors for renal involvement. In contrast, joint involvement was not associated with renal involvement. Among biochemical markers, high red blood cell distribution width is a risk marker of renal involvement in HSP. In contrast, peripheral blood immunoglobulin A, antinuclear antibody, anti-streptolysin O titer, erythrocyte sedimentation rate, and C-reactive protein were not associated with renal involvement. In several studies, leukocytosis, thrombocytosis, or thrombocytopenia have been mentioned as predictors for renal involvement. Still, other studies showed the white blood cell count or platelet count are not risk factors. The effect of corticosteroids as a predictive factor of renal involvement in HSP is challenging and controversial. Furthermore, their impact was dose-dependent. Conclusions: Demographic factors, clinical features, and some abnormal laboratory findings are significant predictive factors for renal involvement in HSP.

The Factors Affecting the Occurrence of Renal Involvement in Children with IgA Vasculitis

Introduction: Henoch-Schönlein purpura or IgA vasculitis that involves small vessels is the most common vasculitis in childhood and the long term prognosis is contingent on the severity of renal involvement. Objectives: In this study, we aimed to determine the frequency of organ involvements and to identify potential risk factors for renal involvement in children with IgA vasculitis. Materials and Methods: This study included 416 patients with IgA vasculitis who had been followed in our department between 1990 and 2016. The patients were retrospectively reviewed in terms of type of treatment, organ involvement and clinical outcome, and potential risk factors for renal involvement were determined. Results: Overall, 416 patients with IgA vasculitis were identified, including 174 girls (41.7%) and 242 boys (58.3%). The mean age at presentation was 8.3±3.1 years. The distribution of organ involvement was: skin involvement, 100%; joint involvement, 77.1%; gastrointestinal system (GIS) involvement, 58.6%; renal involvement, 38.3%; scalp edema, 10.1%; scrotal involvement, 5.3% (9.0% in boys), central nervous system (CNS) involvement, 1.6% and pulmonary involvement, 0.25%. When risk factors for renal involvement were assessed, it was found that GIS involvement was more frequently seen in patients with nephritis (p=0.01). Age, diastolic blood pressure and GIS involvement at the onset were found to be correlated with renal involvement. GIS involvement and diastolic blood pressure were found as risk factors for renal involvement. Conclusion: Age, elevation in diastolic blood pressure and GIS involvement were important findings in prediction of nephritis. In particular, patients with GIS involvement should be cautiously monitored for renal involvement.

Risk Factors for Renal Involvement in Patients with Immunoglobulin A Vasculitis/Henoch–Schönlein Purpura: An Updated Review

Risk Factors for Renal Involvement in Patients with Immunoglobulin A Vasculitis/Henoch–Schönlein Purpura: An Updated Review

Urinalysis monitoring in children with Henoch-Schönlein purpura: Is it time to revise?

To describe the natural history and risk factors of renal involvement in our Henoch-Schönlein purpura (HSP) inception cohort. HSP patients followed at our center for at least 6months between 1/2009-4/2017 were included. A 2-year urinalysis (UA) monitoring protocol was adopted (6monthly and another 6 of 3monthly UA). Renal involvement included minimal renal involvement defined as isolated hematuria (urine red blood cells >5/high-power field or 10/µL) and/or proteinuria (urine protein >1+), and renal impairment defined as nephritic, nephrotic symptoms, or renal insufficiency. Recurrent HSP were excluded. Kaplan-Meier estimates and log-rank test were used to analyze the duration to onset and resolution of abnormal UA. Relationships between demographic and clinical features and renal involvement were studied using logistic regression analyses. Two hundred and thirty-eight patients (52.9% male) were analyzed. Median duration of follow up was 20.6 (interquartile range 11.3-24.4) months. Eighty-nine children (37.4%) developed abnormal UA either at diagnosis (n=43), or during follow up (n=46), mostly (91.0%) within 6months. Seventeen patients (7.1%) developed renal impairment. Among patients without renal impairment, an earlier subsidence (P=0.008) was noted in those with normal UA at diagnosis and most abnormal UA resolved by 18months in this subgroup. Older age at diagnosis was a risk factor of renal involvement (P<0.001). Prednisolone therapy for non-renal indications did not affect the onset or duration of renal involvement. Normal UA at diagnosis indicated a shorter duration of renal involvement. We propose a curtailed duration of follow up for those with normal and abnormal UA at diagnosis.

Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura.

This study aims to evaluate the frequency of skin, gastrointestinal, joint, and renal involvement in children with Henoch-Schönlein purpura and investigate the risk factors for organ/system involvement. The data of 186 patients (97 boys, 89 girls; mean age 7.4±2.8 years; range 1.5 to 16.5 years) who were followed-up with the diagnosis of Henoch-Schönlein purpura in our clinic between October 2011 and December 2013 were evaluated retrospectively. Logistic regression analysis revealed that the risk of gastrointestinal system involvement was significantly higher in patients with skin lesions in the upper extremities (p=0.002, odds ratio [OR]=3.2). The risk of joint involvement was significantly higher in girls (p=0.024, OR=2.18), in patients with soft tissue swelling (p=0.005, OR=2.63), and with low mean platelet volume levels (p=0.008, OR=4.07). The risk of renal involvement was significantly higher in girls (p=0.047, OR=2.7), in patients >10 years (p=0.001, OR=1.4), and in patients with elevated C-reactive protein levels (p=0.007, OR=6.57). Having skin lesions in the upper extremities is a risk factor for gastrointestinal system involvement. Female sex, soft tissue swelling, and low mean platelet volume levels are risk factors for joint involvement. Female sex, >10 years of age, and high C-reactive protein levels are risk factors for renal involvement. Renal involvement in Henoch-Schönlein purpura is independent of gastrointestinal system or joint involvement and very close follow-up is required in the acute period particularly in girls >10 years with high C-reactive protein levels.

Risk factors for renal involvement and severe kidney disease in 2731 Chinese children with Henoch-Schönlein purpura: A retrospective study.

To identify the risk factors for developing renal involvement and severe kidney disease in Chinese childhood Henoch–Schönlein purpura (HSP) patients.This was a retrospective study of 2731 children with HSP diagnosed between 2012 and 2015. We analyzed their demographic data, clinical manifestations, and laboratory tests retrospectively. Multivariate logistic regression analysis was used to assess the risk factors.Renal involvement occurred in 844 HSP patients (35.60%), and severe kidney disease occurred in 104 HSP patients (4.39%). Age over 6 years old at onset, colder season, more than 8 days interval between symptom onset and diagnosis, residence in rural, recurrence, angioedema, and the central nervous system (CNS) involvement were the significant risk factors for renal involvement. At the same time, age over 6 years at onset, more than 8 days interval between symptom onset and diagnosis, recurrence, angioedema, and CNS involvement were highly associated with severe kidney disease. Angioedema, longer interval between symptom onset and diagnosis, older age at HSP onset, and recurrence are prognostic indicators for renal involvement and severe kidney disease in children with HSP. The onset in colder season and rural residence associated with an increased risk for renal involvement, and the CNS involvement had an increased risk for severe kidney disease.HSP tends not to be self-limiting, and could progress into renal involvement or severe kidney disease for some of the HSP patients. Pediatricians should pay more attention to the children diagnosed with HSP, who also have these risk factors, for potential to develop renal involvement, and severe kidney disease, especially.

Henoch Schönlein Purpura in children: Clinical features and risk factors for renal involvement

Objective: This study aimed to evaluate the clinical and laboratory features of children diagnosed with Henoch Schonlein purpura (HSP), risk factors of renal involvement and their effect on prognosis. Methods: A total of 80 pediatric HSP patients (44 males and 36 females) between ages 2 to 13 (average age 7.68±3.09) admitted to the Pediatrics Clinic and follow-up cases from the Pediatric Rheumatology and Nephrology Clinic of the Istanbul Medeniyet University, Goztepe Training and Research Hospital, between April 1998 and June 2003 were enrolled for the study. In order to precisely evaluate glomerular and tubular function, urinary β 2 microglobulin, microalbumin and tubular reabsorption of phosphorus (TRP) were determined. Results: A retrospective evaluation of the HSP patients showed that 26 (32.5%) had symptoms of renal impairment. In terms of renal function, 20 (25%) out of the 54 asymptomatic children initially subjected to routine renal tests had renal involvement. In terms of age, there was a significant difference (p < 0.016) in developing renal involvement between patients above 5 years old and those younger than 5 years. Conclusion: It was therefore suggested that long-term follow-ups in addition to examinations such as routine kidney function tests, tubular reabsorption of phosphate (TRP) and microalbumin levels should be conducted in order to detect the early phase of renal damage.

Risk Factors of Renal Involvement Based on Different Manifestations in Patients with Ankylosing Spondylitis

Background/Aims: Renal involvement is one of the most common extra-articular complications caused by ankylosing spondylitis (AS). Most studies have focused on the incidence rate, clinical manifestation and pathology, while risk factors have hardly been investigated. Therefore, the objective of this study was to assess the risk factors of renal involvement in patients with AS. Methods: Clinical and biochemical data of 926 AS patients were collected. Based on the manifestations of renal involvement, patients were divided into three groups and the differences in clinical and biochemical characteristics were compared. A group with non-renal involvement served as a control. Multivariable logistic regression was used for analyzing risk factors of renal involvement in AS. Results: Of the 926 AS patients, 201 patients suffered from renal involvement. Moreover, female AS patients faced a higher risk of hematuria compared to male patients. As indicated by the data obtained from multivariate logistic regression analysis, gender, uric acid (UA), immunoglobulin A (IgA), and serum albumin (ALB) were found to be risk factors of renal involvement in AS. An increase in UA or IgA levels, or a decrease in ALB level can increase the risk of renal involvement with multiple manifestations (more than one manifestation of renal damage). According to our findings, no definite variable was identified as a risk factor of proteinuria in AS patients. Conclusion: In AS patients, UA, IgA, and ALB levels can indicate the risk of renal involvement in AS patient and need to be paid special attention. Furthermore, women are subjected to a higher risk of hematuria.

Clinical Features and Prognosis of Henoch-Schönlein Purpura in Children and Adults: A 13-Year Retrospective Study at a Single Centre

Purpose To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-Schönlein purpura (HSP). Methods A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome. Key words: Henoch-Schönlein Purpura; Children; Adult; Clinical feature; Prognosis

Obesity increases the risk of renal involvement in children with Henoch-Schönlein purpura.

The main aim of this study was to evaluate the relationship between obesity and renal involvement in children with Henoch-Schönlein purpura (HSP). A retrospective study of 141 pediatric patients with HSP was conducted in our hospital. The clinical data of all patients were collected from the electronic medical record management system from January 2010 to June 2014. The possible risk factors of renal involvement, especially obesity, were analyzed using univariate and multivariate analyses. Renal involvement occurred in 45/141 of the patients. A univariate analysis showed that an age more than 7 years at onset, persistent purpura, obesity, time from symptoms onset to diagnosis more than 14 days, and decreased C3 all increased the risk of renal involvement in HSP. The forward stepwise logistic regression analysis indicated obesity (odds ratio (OR) 4.43, 95 % confidence interval (CI) 1.896 to 10.358), age more than 7 years at onset (OR 2.81, 95 % CI 1.142 to 6.907), and persistent purpura (OR 2.57, 95 % CI 1.119 to 5.909) were independent risk factors for renal involvement. Our results show that obesity can increase the hazard of renal involvement in children with HSP and reconfirm that older age at onset and persistent purpura are the independent risk factors for renal involvement. • There have been some reports that obesity was associated with the development of renal injury. • It is not clear whether obesity can increase the risk of renal involvement in children with HSP. What is New: • The main finding of this study is that obesity can increase the hazard of renal involvement in children with HSP.

Platelet Counts in Children With Henoch-Schonlein Purpura--Relationship to Renal Involvement.

The aim of this study is to identify the clinical and laboratory risk factors for renal involvement and to determine the relationship between platelet counts and renal involvement in (Henoch-Schönlein purpura) HSP patients. We reviewed the medical records of 107 children with HSP according to Eular/Press diagnostic criteria. Clinical and laboratory parameters for renal involvement were evaluated and compared to no renal involvement. A retrospective study consisted of 107 children, 61 boys (57%), and 46 girls (43%). Twenty-eight of the 107 patients (26.1%) had renal involvement. The mean platelet count was significantly higher in patients with renal involvement when compared to patients without renal involvement (P = 0.001). The multivariate logistic regression analysis identified that age (P = 0.022), sex (P = 0.037), gastrointestinal involvement (P = 0.019), and platelet count (P = 0.019) were significantly associated with the renal involvement of HSP. The platelet count was predictive of renal involvement, which had odds ratio of 1.0, and achieved area under the curve of 0.66 for predicting the renal involvement within the acute stage of HSP (P = 0.009). Our study indicated that age, sex, gastrointestinal involvement, and platelet count were significant risk factors of renal involvement of HSP.

Henoch-Schönlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement.

To analyse the clinical features of Henoch-Schönlein purpura (HSP) with or without nephritis in Chinese children and to determine the risk factors for renal involvement. Patient characteristics, clinical parameters and laboratory data were retrospectively analysed in patients with HSP with or without nephritis. Logistic regression analysis was used to identify the risk factors for renal involvement. A total of 535 patients with HSP were included in the study. HSP nephritis occurred in 267 patients (49.9%), ranging from isolated haematuria in 5.2%, mild proteinuria in 77.5%, moderate proteinuria in 6.4% and severe proteinuria in 10.9% of cases. In 90% of the cases, nephritis developed within 1 week of HSP onset; 98.5% of the cases with nephritis developed the condition within 1 month. Risk factors for the development of nephritis were age ≥6 years, purpura on sites other than the lower limbs and the presence of occult blood in the stool. These results suggest that patients aged ≥6 years, or who have purpura on the upper limbs or face, or who have occult blood in the stool should be particularly monitored for signs of nephritis.

Risk factors for renal involvement and progression in SLE

Risk factors for renal involvement and progression in SLE