TY - JOUR
T1 - Clinico-pathological features and outcome in adult patients with Henoch-Schönlein purpura nephritis
AU - Tsuruta, Yuki
AU - Takei, Takashi
AU - Takano, Mari
AU - Sawara, Yukako
AU - Aoki, Akiko
AU - Eguchi, Aya
AU - Kojima, Chiari
AU - Moriyama, Takahito
AU - Itabashi, Mitsuyo
AU - Sugiura, Hidekazu
AU - Tsukada, Misao
AU - Ogawa, Tetsuya
AU - Yoshida, Takumi
AU - Uchida, Keiko
AU - Tsuchiya, Ken
AU - Nitta, Kosaku
PY - 2010
Y1 - 2010
N2 - We examined the data of 24 patients with Henoch-Schönlein purpura nephritis (HSPN) over a 5-year follow-up period. Proteinuria, sediment RBC and CRP significantly decreased between the time of diagnosis and the end of the 5-year period. In the steroid usage group (n= 16), proteinuria was significantly higher, and crescent formation was significant higher at the time of diagnosis than in the non-steroid usage group (n=8). However, there was no significant difference in the decrease in eGFR from the baseline at the end of the 5-year period between the two groups. Furthermore, to clarify the factors influencing the risk of renal function deterioration, we divided the patients into two groups, the (ΔeGFR/pre eGFR) <0.25 group (n= 13) and (ΔeGFR/pre eGFR) >0.25 group(n=11), and compared the clinico-pathophysiological characteristics between the two groups. In the (ΔeGFR/pre eGFR) >0.25 group, the ratio of glomerular obsolescence at the time of diagnosis was significantly higher than in the (ΔeGFR/pre eGFR) <0.25 group. Glomerular obsolescence was identified as an independent risk factor for renal function deterioration. In this study, the prognosis of HSPN was related to glomerular obsolescence rather than to the disease activity. It may be necessary to consider the decrease in nephrons, in accordance with non-immunological glomerular obsolescence, in addition to immunological treatment to clarify the prognosis.
AB - We examined the data of 24 patients with Henoch-Schönlein purpura nephritis (HSPN) over a 5-year follow-up period. Proteinuria, sediment RBC and CRP significantly decreased between the time of diagnosis and the end of the 5-year period. In the steroid usage group (n= 16), proteinuria was significantly higher, and crescent formation was significant higher at the time of diagnosis than in the non-steroid usage group (n=8). However, there was no significant difference in the decrease in eGFR from the baseline at the end of the 5-year period between the two groups. Furthermore, to clarify the factors influencing the risk of renal function deterioration, we divided the patients into two groups, the (ΔeGFR/pre eGFR) <0.25 group (n= 13) and (ΔeGFR/pre eGFR) >0.25 group(n=11), and compared the clinico-pathophysiological characteristics between the two groups. In the (ΔeGFR/pre eGFR) >0.25 group, the ratio of glomerular obsolescence at the time of diagnosis was significantly higher than in the (ΔeGFR/pre eGFR) <0.25 group. Glomerular obsolescence was identified as an independent risk factor for renal function deterioration. In this study, the prognosis of HSPN was related to glomerular obsolescence rather than to the disease activity. It may be necessary to consider the decrease in nephrons, in accordance with non-immunological glomerular obsolescence, in addition to immunological treatment to clarify the prognosis.
KW - Glomerular obsolescence
KW - HSPN
KW - Renal function
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M3 - Article
C2 - 20166542
AN - SCOPUS:77249170900
SN - 0385-2385
VL - 52
SP - 51
EP - 57
JO - Japanese Journal of Nephrology
JF - Japanese Journal of Nephrology
IS - 1
ER -