Document Detail


Predictors of outcome in Henoch-Schönlein nephritis.
MedLine Citation:
PMID:  20174831     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Factors predictive of renal outcome were studied in 78 children with Henoch-Schönlein nephritis followed up for as long as 17 (mean 5.2) years. Patients with a good outcome (74%) were healthy or had microalbuminuria or mild proteinuria at the final follow-up (FU), and those with poor outcome (26%) had active renal disease or chronic kidney disease at stages IV-V. Patients with mild symptoms at onset (hematuria + or - mild proteinuria) had a poor outcome in 15% of cases versus 41% of those with severe symptoms (nephritic or nephrotic syndrome or nephritic-nephrotic picture) (p = 0.011). However, among patients with mild proteinuria at onset, 18% showed a poor prognosis; non-nephrotic proteinuria with a urine albumin/creatinine ratio at a cut-off value of >144 mg/mmol at the 1-year FU was predictive of a poor outcome. Among 59 biopsied patients, 37% of those with advanced histological findings [International Study of Kidney Disease in Children (ISKDC) stages III-V] had a poor outcome compared to none of those with mild findings (ISKDC stages I-II) (p = 0.0015). Patients with a poor outcome were older at onset, had more proteinuria, and lower glomerular filtration rate at the 1-year FU compared with patients with a good outcome. Multivariate analysis showed that proteinuria at the 1-year FU and the ISKDC grading score of the renal biopsy were the two most discriminant factors of a poor prognosis.
Authors:
Stella Edström Halling; Magnus P Söderberg; Ulla B Berg
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-20
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  25     ISSN:  1432-198X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-16     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1101-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Science, Intervention and Technology, Division of Pediatrics, Karolinska Institutet, Astrid Lindgren Children s Hospital, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden. stella.edstrom.halling@ki.se
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Child
Child, Preschool
Female
Glomerular Filtration Rate
Humans
Immunosuppressive Agents / therapeutic use
Male
Prognosis
Purpura, Schoenlein-Henoch / drug therapy,  physiopathology*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Immunosuppressive Agents

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