Elena Tudorache 1,2 , Christine Azema 1 , Julien Hogan 1 , Hala Wannous 1 , Bilal Aoun 1 , Stéphane Decramer 3 , Georges Deschênes 4,5 , Tim Ulinski 1,2 Show Affiliations »
Abstract
AIM: Henoch-Schonlein purpura (HSP) is a common cause of paediatric renal disease in children, representing 10-15% of paediatric glomerulonephritis. This study examined the long-term outcome of biopsy-proven HSP nephritis to identify correlations between disease development and treatment. METHODS: Patients from three French centres were retrospectively analysed. RESULTS: We followed up 142 patients aged from 2 to 10.5 years with HSP nephritis, graded according to the International Study Group of Kidney Disease in Childhood classification. Mean (±SD) age at presentation was 7.6 ± 2.8 years. Nephrotic range proteinuria was present in 28% of patients with Grade II lesions, 60% with Grade III and 90% with Grade IV. Significant proteinuria (>0.5 g/L) was found in nine of 48 patients 3 years after renal biopsy, eight of 25 patients after 5 years and three of 14 patients after 10 years. There was no correlation between the proteinuria risk at 3, 5 or 10 years and the initial histological lesion or treatment modality. Treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) was linked to lower proteinuria, especially if it was started precociously. CONCLUSION: Even mild forms of HSP nephritis risk significant long-term proteinuria. Very early introduction of ACEi/ARB may improve the long-term outcome independent of histological lesions. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
AIM: Henoch-Schonlein purpura (HSP) is a common cause of paediatric renal disease in children , representing 10-15% of paediatric glomerulonephritis . This study examined the long-term outcome of biopsy-proven HSP nephritis to identify correlations between disease development and treatment. METHODS: Patients from three French centres were retrospectively analysed. RESULTS: We followed up 142 patients aged from 2 to 10.5 years with HSP nephritis , graded according to the International Study Group of Kidney Disease in Childhood classification. Mean (±SD) age at presentation was 7.6 ± 2.8 years. Nephrotic range proteinuria was present in 28% of patients with Grade II lesions, 60% with Grade III and 90% with Grade IV. Significant proteinuria (>0.5 g/L) was found in nine of 48 patients 3 years after renal biopsy, eight of 25 patients after 5 years and three of 14 patients after 10 years. There was no correlation between the proteinuria risk at 3, 5 or 10 years and the initial histological lesion or treatment modality. Treatment with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) was linked to lower proteinuria , especially if it was started precociously. CONCLUSION: Even mild forms of HSP nephritis risk significant long-term proteinuria . Very early introduction of ACEi/ARB may improve the long-term outcome independent of histological lesions. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Entities: Disease
Species
Keywords:
Angiotensin receptor blockers; Angiotensin-converting enzyme inhibitors; Henoch-Schonlein purpura; Proteinuria; Renal biopsy
Mesh： See more »
Year: 2014
PMID： 24946692 DOI： 10.1111/apa.12723
Source DB: PubMed Journal: Acta Paediatr ISSN： 0803-5253 Impact factor: 2.299