Significance of serum cholesterol and fibrinogen in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the significance of serum cholesterol and fibrinogen (Fib) in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome.</p><p><b>METHODS</b>Sixty-three children with primary nephrotic syndrome were divided into two groups according to their pathological types: minimal change glomerulopathy (MCG) (n=39) and focal segmental glomerulosclerosis (FSGS) groups (n=24). Serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C and Fib and 24-hour urinary protein excretion were retrospectively analyzed.</p><p><b>RESULTS</b>Serum levels of TC, non-HDL-C, and LDL-C were significantly higher in the FSGS group than in the MCG group (P<0.05), but there were no significant differences in HDL-C, Fib and 24-hour urinary protein excretion between the two groups (P>0.05). According to the results of logistic regression analysis, high levels of LDL-C, non-HDL-C and TC were risk factors for FSGS (P<0.05). In patients whose proteinuria did not disappear after taking enough glucocorticoid for 4 weeks, the level of non-HDL-C was significantly higher in the FSGS group than in the MCG group (P<0.05); there were no significant differences in TC, LDL-C, HDL-C, and Fib between the MCG and FSGS groups (P>0.05).</p><p><b>CONCLUSIONS</b>Serum cholesterol, especially non-LDL-C, is of great significance in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome. There is no sufficient evidence to support serum Fib as a marker for predicting glomerulosclerosis in these children.</p>

Analysis of clinical and pathological characteristics in 167 children with Henoch Sch(o)nlein purpura nephritis / 中华实用儿科临床杂志

Objective To investigate the clinical,renal pathological characteristics of Henoch Sch(O)nlein purpura nephritis (HSPN) in children.Methods One hundred and sixty-seven children hospitalized with HSPN from Jan.2008 to Dec.2011 in the First Affiliated Hospital of Zhengzhou University were divided into 2 groups by 24-hour urinary protein quantity:group A with 24-hour urinary protein quantity ＜ 25 mg/kg,group B with 24-hour urinary protein quantity ≥ 25 mg/kg.Age of onset,gender,injury time of kidney,clinical manifestations,24-hour urinary protein quantity and renal pathological grades of the 2 groups were collected and analyzed.Results In 167 HSPN children,the ratio of male to female was 1.8:1.0.The ages from 5 to 10 years old accounted for 70.7％.Renal injurytime was from a day to 5 months,91.6％ of the HSPN children occurred renal damage within 1 month.HSPN children had clinical signs of gastrointestinal involvement in 56 cases(33.5％),at the same time,the digestive tract and joint involvement in 52 cases(31.1％).Pathological classification of 6 grades:8 cases(4.8％) of grade Ⅰ ;32 cases(19.2％) of grade Ⅱ ;124 cases (74.3 ％) of grade Ⅲ ;3 cases (1.8％) of grade Ⅳ ; no grade Ⅴ or Ⅵ.Pathologic grade of group B was higher than group A,and the difference was significant (P ＜ 0.05).Conclusions The HSPN children,expecially the boys,were more found with digestive tract injury or multiple organ damage.Most HSPN children occurred renal damage within 1 month.The renal biopsy of HSPN children should be positive,especially when the 24-hour urinary protein quantity is ≥25 mg/kg.