scholarly journals Prediction of Renal Damage in Children with Henoch-Schönlein Purpura Based on Machine Learning

Author(s):  
Jinjuan Wang ◽  
Huimin Chu ◽  
Yueli Pan

Abstract Background This article is objected to explore the value of machine learning algorithm in predicting the risk of renal damage in children with Henoch-Schönlein Purpura, and to construct a predictive model of Henoch-Schönlein Purpura Nephritis in children and analyze the related risk factors of Henoch-Schönlein Purpura Nephritis in children. Methods Case data of 288 hospitalized children with Henoch-Schönlein Purpura from November 2018 to October 2021 were collected. The data included 42 indicators such as demographic characteristics, clinical symptoms and laboratory tests, etc. Univariate feature selection was used for feature extraction, and Logistic regression, support vector machine, decision tree and random forest algorithm were used respectively for classification prediction. Last, the performance of four algorithms are compared using accuracy rate and recall rate. Results The accuracy rate, recall rate and AUC of the established random forest model were 0.83, 0.86 and 0.91 respectively, which were higher than 0.74, 0.80 and 0.89 of the Logistic regression model; higher than 0.70, 0.80 and 0.89 of support vector machine model; higher than 0.74, 0.80 and 0.81 of the decision tree model. The top 10 important features provided by random forest model are Persistent purpura≥4weeks, Cr, Clinic time, ALB, WBC, TC, TG, Relapse, TG, Recurrent purpura and EB-DNA. Conclusion The model based on random forest algorithm has better performance in the prediction of children with allergic purpura renal damage, indicated by better classification accuracy, better classification effect and better generalization performance.

Author(s):  
Eda Didem Kurt-Şükür ◽  
Thivya Sekar ◽  
Kjell Tullus

Abstract Background Knowledge on normal progress and treatment of Henoch-Schönlein purpura nephritis (HSPN) is limited. This study reviews outcome, clinical, pathological, and therapeutic factors affecting the prognosis of HSPN patients. Methods Forty-nine children with biopsy-confirmed HSPN diagnosed between September 2008 and 2018 were included. Demographics, clinical and laboratory data, treatment, and outcome were recorded at the time of biopsy, 3, 6, 12, and 24 months and at last visit. Clinical outcome was graded according to Meadow’s criteria. Results The median age at time of biopsy was 10.1 years (IQR:5.7) and female/male ratio 24/25. At presentation, 40.8% of patients had nonnephrotic proteinuria, 18.4% nephrotic syndrome (NS), 4.1% nephritic syndrome (NephrS), and 36.7% NephrS+NS. There were 11 patients with an estimated glomerular filtration rate below 90 ml/min/1.73 m2. Biopsy specimens were classified according to International Study of Kidney Diseases in Children (ISKDC) and Oxford Classification MEST-C scoring systems. Forty-one patients received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, 37 patients steroids, and 35 patients other immunosuppressive medications. At last visit, 24 patients had stage 1 chronic kidney disease (CKD), three stage 2 CKD, and two had stage 5 CKD. Neither clinical parameters nor ISKDC biopsy grade or treatment modalities effected the final outcome. The Oxford classification showed significantly increased segmental glomerulosclerosis in patients with unfavorable outcome. Favorable outcome was associated with shorter time from kidney involvement to biopsy and start of treatment. Conclusion A large proportion of patients continued to show signs of CKD at last follow-up while only a small proportion developed stage 5 CKD.


2018 ◽  
Vol 34 (4) ◽  
pp. 663-670 ◽  
Author(s):  
Xiao-qing Yang ◽  
Yan-jie Huang ◽  
Wen-sheng Zhai ◽  
Xian-qing Ren ◽  
Qing-yin Guo ◽  
...  

2010 ◽  
Vol 42 (4) ◽  
pp. 1023-1029 ◽  
Author(s):  
Yukihiko Kawasaki ◽  
Kazuhide Suyama ◽  
Eichi Yugeta ◽  
Masahiko Katayose ◽  
Shigeo Suzuki ◽  
...  

2021 ◽  
Vol 73 (10) ◽  
pp. 687-694
Author(s):  
Thanaporn Chaiyapak ◽  
Anirut Pattaragarn ◽  
Suroj Supavekin ◽  
Nuntawan Piyaphanee ◽  
Kraisoon Lomjansook ◽  
...  

Background: Henoch-Schönlein purpura nephritis (HSPN) is considered the systemic form of IgA nephropathy (IgAN). However, differing clinicopathological features and renal outcomes of children with IgAN and HSPN have been reported in some studies. Methods: This study retrospectively reviewed children with IgAN and HSPN younger than 18 years, between January 2004 and December 2015. The clinicopathological characteristics at diagnosis and the renal outcomes after at least 1 year of follow-up were compared between the two groups. Results: A total of 54 children, comprising 21 with IgAN and 33 with HSPN, were recruited. The children with HSPN were younger than the children with IgAN. Gross hematuria and nephritic syndrome at the initial presentation were more common in children with IgAN. Regarding the pathological findings, IgAN had greater chronicity than HSPN. After a median follow-up period from first presentation to renal outcomes measurement of 4.0 years (1.3-12.2) in children with IgAN and 4.2 years (1.1-11.4) in children with HSPN, the renal outcomes were better in the latter group. The incidence of chronic kidney disease (CKD) was 28.6% in children with IgAN and 6.1% in children with HSPN (p = 0.02). Complete recovery was observed more frequently in children with HSPN than in children with IgAN (57.1% in IgAN vs. 87.9% in HSPN, p = 0.01). Conclusions: Childhood IgAN has greater chronicity and worse renal outcomes than childhood HSPN, with a lower rate of complete recovery and a higher frequency of CKD. We recommend long-term follow-up for CKD in children with IgAN.


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