Clinical outcome of children with Henoch-Schönlein purpura nephritis

Abstract

Objective: Evaluate the outcomes of pediatric patients with Henoch-Schönlein purpura nephritis and find the parameters correlated with outcomes of treatment. Material and Method: Review of medical records was performed in twenty patients diagnosed with Henoch-Schönlein purpura nephritis. Demographic data, clinical parameters and records of treatment at diagnosis and the last visit were collected and analyzed. Results: Median age at diagnosis was 8-year-old and median follow-up time was 39 months. All patients had urine protein to creatinine ratio (UPCR) of more than 1.0 g/g while ten patients had hypoalbuminemia. Renal pathology results were class I, II, and III in 2, 14, and 4 patients respectively. Prednisolone was prescribed in all patients and cyclophosphamide was given in 13 patients. All patients had first resolution of proteinuria at median time of six months (range 2-47 months). At the last visit, 13 patients (65%) had remission of proteinuria (remission group), while seven patients (35%) became proteinuric relapse (relapse group) with UPCR > 0.2 g/g. Interestingly, the remission group had median time to first resolution of proteinuria shorter than the relapse group (6 months and 19 months, p < 0.001). Moreover, estimated glomerular filtration rate at diagnosis correlated negatively with UPCR at the last visit (r = -0.773, p = 0.001). Conclusion: Pediatric patients with Henoch-Schönlein purpura nephritis who presented with heavy proteinuria had favorable outcome after treatment. The patients who had early resolution of proteinuria remained in remission more than those who had late resolution.