Even mild cases of paediatric Henoch‐Schönlein purpura nephritis show significant long‐term proteinuria. (29th July 2014)

• Record Type: Journal Article
• Authors: Tudorache, Elena; Azema, Christine; Hogan, Julien; Wannous, Hala; Aoun, Bilal; Decramer, Stéphane; Deschênes, Georges; Ulinski, Tim
• Is Part Of: Acta pædiatrica. Volume 104:Number 8(2015:Aug.)
• Page Start: 843
• Page End: 848
• Publication Date: 2014-07-29
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12723
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12723-abs-0001"> <title>Abstract</title> <sec id="apa12723-sec-0001" sec-type="section"> <title>Aim</title> <p>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.</p> </sec> <sec id="apa12723-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients from three French centres were retrospectively analysed.</p> </sec> <sec id="apa12723-sec-0003" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="apa12723-sec-0004" sec-type="section"> <title>Conclusion</title> <p>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.</p> </sec> </abstract>