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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Pediatr+Rheumatol+Online+J
2017 ; 15
(1
): 15
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A single-center analysis of Henoch-Schonlein purpura nephritis with nephrotic
proteinuria in children
#MMPMID28257644
Feng D
; Huang WY
; Hao S
; Niu XL
; Wang P
; Wu Y
; Zhu GH
Pediatr Rheumatol Online J
2017[Mar]; 15
(1
): 15
PMID28257644
show ga
BACKGROUND: In children with Henoch-Schonlein purpura nephritis (HSPN), the
degree of proteinuria has been proven to be not only a sign of kidney damage, but
also an accelerator of kidney disease progression. Nephrotic proteinuria at
disease onset has been proposed as a predictor of a poor renal outcome. This
study aims to assess the clinical and pathological features of HSPN with
nephrotic proteinuria in a single center. METHODS: One hundred thirty-seven
patients with HSPN who visited Shanghai Children's Hospital from January 2009 to
December 2013 were retrospectively reviewed. The patients were divided into 2
groups based on the 24-h urinary protein levels: nephrotic proteinuria group (NP
group: 24-h urinary protein ?50 mg/kg) and non-nephrotic proteinuria group (NNP
group: 24-h urinary protein <50 mg/kg). In addition, data regarding their sex,
age, clinical features, renal pathology, and prognosis were collected. RESULTS:
(1) There were 34 boys and 20 girls in the NP group with a mean age of
8.39?±?2.85 years. The peak age of incidence was 6 to 11 years (72.22%). (2)
There were 8 cases (14.81%) with joint symptoms and 9 cases (16.67%) with
gastrointestinal symptoms in the NP group. According to the analysis of the
laboratory test results, the serum albumin and IgG levels of the NP group were
significantly lower than that of the NNP group (35.04?±?8.45 in the NP group vs.
41.55?±?4.46 in the NNP group, P?0.0001; 7.68?±?3.12 in the NP group vs.
9.53?±?2.74 in the NNP group, P?0.001, respectively); their blood urea nitrogen
and cystatin C levels increased significantly (P?0.05). (3) The majority of the
pathological changes in the NP group were above the International Study of Kidney
Disease in Children (ISKDC) grade III (62.97%). The NP group patients with
tubulointerstitial injurie with grade 2 and above (50%) were prioritized. Immune
complex deposition in the NP group was dominated by IgA. (4) The prognosis of the
NP group was in complete remission (A), and their cases did not develop into
end-stage renal disease; their prognosis was also associated with clinical
classification (P?0.01) but was not related to pathologic grading and
tubulointerstitial injury (P?>?0.05). CONCLUSION: The serum albumin and IgG
levels of the NP group were significantly lower; however, their blood urea
nitrogen and cystatin C levels were higher. The ISKDC grades were mainly above
grade III. The prognosis of the NP group was associated with clinical
classification and improved after a timely and early treatment.