Authors: Hitoshi Wakaki Kenji Ishikura Hiroshi Hataya Yuko Hamasaki Tomoyuki Sakai Nahoko Yata Tetsuji Kaneko Masataka Honda
Publish Date: 2011/03/04
Volume: 26, Issue: 6, Pages: 921-925
Abstract
Nephritis develops in 18–81 of HenochSchönlein purpura patients and the longterm outcomes of this nephritis show great variation A nephrotic state at disease onset has been proposed as a predictor of poor renal outcomes We studied 42 children with HenochSchönlein purpura nephritis HSPN who presented with a nephrotic state during the early phase of the disease The median age of the patients at the time of diagnosis was 74 years The median followup period was 62 years Twentyfive children 60 made a complete recovery nine 21 progressed to endstage renal disease Multivariate logistic regression analyses revealed that the nephrotic state lasting for more than 3 months had a significant effect on renal outcomes odds ratio 116 95 confidential interval 116–3484 p = 003 whereas initial renal insufficiency renal pathological findings age at onset and types of treatment did not These findings indicate that clinical presentation particularly duration of the nephrotic state is related to longterm outcomes in HSPN patients with nephrosis Our results also indicate that the therapeutic options for HSPN patients with a nephrotic state should be based on the clinical presentation rather than on the initial pathological findings alone
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