Risk factors for renal involvement in Henoch–Schönlein purpura

Abstract Background: The long-term prognosis of Henoch-Schönlein purpura (HSP) depends on the severity of renal involvement, and crescent formation is considered an important risk factor for poor prognosis of Henoch-Schönlein purpura nephritis (HSPN). The objective of this study was to evaluate factors affecting crescent formation in children with HSPN.Methods: Demographic factors, clinical characteristics, and laboratory data of children with HSPN with or without crescents were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of crescent formation in HSPN.Results: A total of 191 children with HSPN were enrolled in the study. There were 107 (56%) males and 84 (44%) females, with a median age of 7 years (range: 2 years–15 years). International Study of Kidney Disease in Children (ISKDC) grading was used to divide subjects into two groups: those without glomerular crescent formation (ISKDC grades I–II, n = 146 cases) and those with glomerular crescent formation (ISKDC grades III–V, n = 45 cases). Logistic regression analysis showed that higher urinary white blood cell (WBC) count (OR = 3.300; 95% CI, 1.119–9.739; P = 0.0306) and higher urinary microalbumin/creatinine ratio (ACR) (OR = 25.053; 95% CI, 1.354–463.708; P = 0.0305) were independent risk factors for the formation of crescents in HSPN. The area under the receiver operating characteristic curve of urinary WBC and ACR were 0.753 and 0.698 respectively, with the Hosmer and Lemeshow goodness-of-fit test (P = 0.0669, P > 0.05).Conclusion: These results suggest that higher urinary WBC count and ACR should be strictly monitored for children with HSPN. Adequate clinical intervention for these risk factors may limit or prevent renal crescent formation.

Download Full-text

Risk Factors Associated With Renal Involvement in Childhood Henoch-schonlein Purpura

Journal of Pediatrics Review ◽

10.32598/jpr.9.1.903.1 ◽

2021 ◽

Vol 9 (1) ◽

pp. 53-60

Author(s):

Maryam Abdollahi ◽

◽

Vadood Javadi ◽

Reza Shiari ◽

Khosro Rahmani ◽

...

Keyword(s):

Risk Factors ◽

Blood Cell ◽

Renal Involvement ◽

Significant Risk ◽

Joint Involvement ◽

Henoch Schonlein Purpura ◽

Distribution Width ◽

Factors Associated ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Context: Henoch-Schonlein purpura (HSP) is a significant cause of chronic renal disease in children. This review determines some risk factors associated with renal involvement in childhood HSP. Evidence Acquisition: Electronic databases, including Google Scholar, PubMed, and Scopus were searched using the following keywords: “children”, “Henoch-Schonlein”, “risk factor”, “renal involvement”, and “IgA vasculitis”. This review was designed to identify the relevant electronic studies published in the English language from December 1998 to August 2018. Results: This review revealed that clinically older age at presentation, persistent rash, atypical rash, rash on unusual location, and gastrointestinal bleeding were significant risk factors for renal involvement. In contrast, joint involvement was not associated with renal involvement. Among biochemical markers, high red blood cell distribution width is a risk marker of renal involvement in HSP. In contrast, peripheral blood immunoglobulin A, antinuclear antibody, anti-streptolysin O titer, erythrocyte sedimentation rate, and C-reactive protein were not associated with renal involvement. In several studies, leukocytosis, thrombocytosis, or thrombocytopenia have been mentioned as predictors for renal involvement. Still, other studies showed the white blood cell count or platelet count are not risk factors. The effect of corticosteroids as a predictive factor of renal involvement in HSP is challenging and controversial. Furthermore, their impact was dose-dependent. Conclusions: Demographic factors, clinical features, and some abnormal laboratory findings are significant predictive factors for renal involvement in HSP.

Download Full-text

Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura

European Journal of Pediatrics ◽

10.1007/s00431-002-0922-z ◽

2002 ◽

Vol 161 (4) ◽

pp. 196-201 ◽

Cited By ~ 80

Author(s):

Hitomi Sano ◽

Michiko Izumida ◽

Hiroshi Shimizu ◽

Yunosuke Ogawa

Keyword(s):

Risk Factors ◽

Renal Involvement ◽

Henoch Schonlein Purpura ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Download Full-text

Henoch Schönlein Purpura in children: Clinical features and risk factors for renal involvement

Medical Science and Discovery ◽

10.17546/msd.432588 ◽

2018 ◽

pp. 267-273 ◽

Cited By ~ 1

Author(s):

Atiye Fedakar

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Renal Involvement ◽

Henoch Schonlein Purpura ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Download Full-text

Risk factors associated with renal crescentic formation in pediatric Henoch–Schönlein purpura nephritis: a retrospective cohort study

10.21203/rs.3.rs-28330/v3 ◽

2020 ◽

Author(s):

Yong-rui Song ◽

Wan-liang Guo ◽

Mao Sheng ◽

Qiang Lin ◽

Xue-ming Zhu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Renal Involvement ◽

Henoch Schonlein Purpura ◽

Goodness Of Fit Test ◽

Crescent Formation ◽

Wbc Count ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura ◽

Purpura Nephritis

Abstract Background: The long-term prognosis of Henoch-Schönlein purpura (HSP) depends on the severity of renal involvement, and crescent formation is considered an important risk factor for poor prognosis of Henoch-Schönlein purpura nephritis (HSPN). The objective of this study was to evaluate factors affecting crescent formation in children with HSPN.Methods: Demographic factors, clinical characteristics, and laboratory data of children with HSPN with or without crescents were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of crescent formation in HSPN.Results: A total of 191 children with HSPN were enrolled in the study. There were 107 (56%) males and 84 (44%) females, with a median age of 7 years (range: 2 years–15 years). International Study of Kidney Disease in Children (ISKDC) grading was used to divide subjects into two groups: those without glomerular crescent formation (ISKDC grades I–II, n = 146 cases) and those with glomerular crescent formation (ISKDC grades III–V, n = 45 cases). Logistic regression analysis showed that higher urinary white blood cell (WBC) count (OR = 3.300; 95% CI, 1.119–9.739; P = 0.0306) and higher urinary microalbumin/creatinine ratio (ACR) (OR = 25.053; 95% CI, 1.354–463.708; P = 0.0305) were independent risk factors for the formation of crescents in HSPN. The area under the receiver operating characteristic curve of urinary WBC and ACR were 0.753 and 0.698 respectively, with the Hosmer and Lemeshow goodness-of-fit test (P = 0.0669, P > 0.05).Conclusion: These results suggest that higher urinary WBC count and ACR should be strictly monitored for children with HSPN. Adequate clinical intervention for these risk factors may limit or prevent renal crescent formation.

Download Full-text

Risk factors associated with renal crescentic formation in pediatric Henoch–Schönlein purpura nephritis: a retrospective cohort study

BMC Pediatrics ◽

10.1186/s12887-020-02404-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yong-Rui Song ◽

Wan-Liang Guo ◽

Mao Sheng ◽

Qiang Lin ◽

Xue-Ming Zhu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Renal Involvement ◽

Henoch Schonlein Purpura ◽

Goodness Of Fit Test ◽

Crescent Formation ◽

Wbc Count ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura ◽

Purpura Nephritis

Abstract Background The long-term prognosis of Henoch-Schönlein purpura (HSP) depends on the severity of renal involvement, and crescent formation is considered an important risk factor for poor prognosis of Henoch-Schönlein purpura nephritis (HSPN). The objective of this study was to evaluate factors affecting crescent formation in children with HSPN. Methods Demographic factors, clinical characteristics, and laboratory data of children with HSPN with or without crescents were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of crescent formation in HSPN. Results A total of 191 children with HSPN were enrolled in the study. There were 107 (56%) males and 84 (44%) females, with a median age of 7 years (range: 2 years–15 years). International Study of Kidney Disease in Children (ISKDC) grading was used to divide subjects into two groups: those without glomerular crescent formation (ISKDC grades I–II, n = 146 cases) and those with glomerular crescent formation (ISKDC grades III–V, n = 45 cases). Logistic regression analysis showed that higher urinary white blood cell (WBC) count (OR = 3.300; 95% CI, 1.119–9.739; P = 0.0306) and higher urinary microalbumin/creatinine ratio (ACR) (OR = 25.053; 95% CI, 1.354–463.708; P = 0.0305) were independent risk factors for the formation of crescents in HSPN. The area under the receiver operating characteristic curve of urinary WBC and ACR were 0.753 and 0.698 respectively, with the Hosmer and Lemeshow goodness-of-fit test (P = 0.0669, P > 0.05). Conclusion These results suggest that higher urinary WBC count and ACR should be strictly monitored for children with HSPN. Adequate clinical intervention for these risk factors may limit or prevent renal crescent formation.

Download Full-text

Risk factors associated with renal crescentic formation in pediatric Henoch–Schönlein purpura nephritis: a retrospective cohort study

10.21203/rs.3.rs-28330/v1 ◽

2020 ◽

Author(s):

Yongrui SONG ◽

Wanliang GUO ◽

Mao SHENG ◽

Qiang LIN ◽

Xueming ZHU ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Renal Involvement ◽

Henoch Schonlein Purpura ◽

Goodness Of Fit Test ◽

Crescent Formation ◽

Wbc Count ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura ◽

Purpura Nephritis

Abstract Background The long-term prognosis of Henoch-Schönlein purpura (HSP) depends on the severity of renal involvement, crescentic formation is considered to be an important risk factor for poor prognosis of Henoch-Schönlein purpura nephritis (HSPN). The objective of this study was to evaluate factors affecting crescent formation in children with HSPN. Methods Demographic factors, clinical characteristics, and laboratory data of children with HSPN with or without crescents were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of crescent formation in HSPN. Results A total of 191 children with HSPN were enrolled in the study. There were 107 (56%) males and 84 (44%) females, with a median age of 7 years (range: 2 years–15 years). International Study of Kidney Disease in Children (ISKDC) grading was used to divide subjects into two groups: those without glomerular crescent formation (ISKDC grades I–II, n = 146 cases) and those with glomerular crescentic formation (ISKDC grades III–V, n = 45 cases). Logistic regression analysis showed that higher urinary white blood cell (WBC) count (OR = 3.300; 95% CI, 1.119–9.739; P = 0.0306) and higher urinary microalbumin/creatinine ratio (ACR) (OR = 25.053; 95% CI, 1.354–463.708; P = 0.0305) were independent risk factors for the formation of crescents in HSPN. The area under the receiver operating characteristic curve of urinary WBC and ACR were 0.753 and 0.698 respectively, with the Hosmer and Lemeshow goodness-of-fit test (P = 0.0669, P > 0.05). Conclusion These results suggest that higher urinary WBC count and ACR should be strictly monitored for children with HSPN. Adequate clinical intervention for these risk factors may limit or prevent renal crescent formation.

Download Full-text