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2018 ; 8
(1
): 5585
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Renal Prognosis and Related Risk Factors for Henoch-Schönlein Purpura Nephritis:
A Chinese Adult Patient Cohort
#MMPMID29615640
Huang X
; Wu X
; Le W
; Hao Y
; Wu J
; Zeng C
; Liu Z
; Tang Z
Sci Rep
2018[Apr]; 8
(1
): 5585
PMID29615640
show ga
This study investigated the clinicopathological characteristics of
Henoch-Schönlein purpura nephritis (HSPN) in Chinese adult patients and analyzed
the renal outcomes and prognostic risk factors for progression to end-stage renal
disease (ESRD). Adult patients who had biopsy-proven HSPN were studied. Their
clinicopathological data, renal prognoses and related risk factors were assessed.
A total of 698 patients were studied, including 363 men (52.0%) and 335 women
(48.0%). Most of the patients had hematuria (85.8%) and/or proteinuria (82.1%).
During a median follow-up of 54.0 months, 32 patients (4.6%) progressed to ESRD.
The 5- and 10-year cumulative renal survival rates from ESRD were 96.4% and
88.6%, respectively. Baseline urinary protein, renal insufficiency, glomerular
sclerosis and tubular atrophy/interstitial fibrosis were independent predictors
of renal outcomes. Both the time-average mean arterial pressure and proteinuria
during follow-up also influenced the renal prognosis. The patients with a
time-average proteinuria <0.4?g/day had the lowest rates of ESRD or a 50% decline
in renal function. In conclusion, identifying of clinical and histological
prognostic factors may permit the prediction of renal outcomes. The optimal goal
of therapy for HSPN patients may be to lower proteinuria to <0.4?g/day and
control hypertension to achieve an ideal renal outcome.