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Renal biopsy in children with IgA vasculitis / Biópsia renal em crianças com vasculite por IgA
Kara, Mehtap Akbalik; Kiliç, Beltinge Demircioğlu; Büyükçelik, Mithat; Balat, Ayşe.
  • Kara, Mehtap Akbalik; Gaziantep University. Faculty of Medicine. Department of Pediatric Nephrology. Gaziantep. TR
  • Kiliç, Beltinge Demircioğlu; Gaziantep University. Faculty of Medicine. Department of Pediatric Nephrology. Gaziantep. TR
  • Büyükçelik, Mithat; Gaziantep University. Faculty of Medicine. Department of Pediatric Nephrology. Gaziantep. TR
  • Balat, Ayşe; Gaziantep University. Faculty of Medicine. Department of Pediatric Nephrology and Rheumatology. Gaziantep. TR
J. bras. nefrol ; 44(1): 48-57, Jan-Mar. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1365024
ABSTRACT
Abstract Introduction Henoch-Schönlein purpura nephritis (HSN) is defined as Henoch-Schönlein purpura with kidney involvement, including hematuria and/or proteinuria. The aim of this study was to evaluate the data of HSN patients who underwent renal biopsy, and compare the main clinical and laboratory parameters that may affect renal biopsy findings, treatment protocols, and short- and long-term outcome of those patients. Methods Biopsies performed in 72 HSN patients between January 2007 to January 2017 were retrospectively evaluated. They were divided into two groups according to renal biopsy classification of the International Study of Kidney Disease in Children. Renal outcome, clinical and laboratory parameters, treatment protocols, and outcome were compared between groups. Short- and long-term follow-up of patients were evaluated. Results Of 72 patients, 47 were male (65.3%) and 44 (61.1%) were ≤10 years of age. Neutrophil-lymphocyte ratio was found higher in patients with scrotal involvement (p=0.042). Short-term unfavorable outcome was significantly higher in patients with scrotal involvement (p=0.038). Patients with hypertension and decreased creatinine clearance were found to have more unfavorable outcomes in long-term follow-up (p=0.029, p=0.040). Conclusion Cyclosporin-A and cyclophosphamide could be effective in steroid unresponsive HSN patients. Patients with scrotal involvement, decreased creatinine clearance, and hypertension should be closely monitored for sequelae of HSN.
RESUMO
Resumo Introdução A nefrite da púrpura de Henoch-Schönlein (NPHS) é definida como púrpura de Henoch-Schönlein com envolvimento renal, incluindo hematúria e/ou proteinúria. O objetivo deste estudo foi avaliar os dados de pacientes com NPHS que foram submetidos à biópsia renal e comparar os principais parâmetros clínicos e laboratoriais que podem afetar os achados da biópsia renal, os protocolos de tratamento e o desfecho de curto e longo prazo desses pacientes. Métodos Foram avaliadas retrospectivamente biópsias realizadas em 72 pacientes com NPHS entre Janeiro de 2007 e Janeiro de 2017. Eles foram divididos em dois grupos de acordo com a classificação de biópsia renal do Estudo Internacional de Doenças Renais em Crianças. O desfecho renal, parâmetros clínicos e laboratoriais, protocolos de tratamento e desfechos foram comparados entre os grupos. Foi avaliado o acompanhamento de pacientes de curto e longo prazo. Resultados De 72 pacientes, 47 eram homens (65,3%) e 44 (61,1%) tinham ≤10 anos de idade. A razão neutrófilo-linfócito foi encontrada mais alta em pacientes com envolvimento escrotal (p=0,042). O desfecho desfavorável de curto prazo foi significativamente maior em pacientes com envolvimento escrotal (p=0,038). Constatou-se que pacientes com hipertensão e diminuição da depuração de creatinina apresentaram desfechos mais desfavoráveis no acompanhamento de longo prazo (p=0,029, p=0,040). Conclusão A ciclosporina-A e a ciclofosfamida podem ser eficazes em pacientes com NPHS não responsivos a esteroides. Pacientes com envolvimento escrotal, diminuição da depuração de creatinina e hipertensão devem ser monitorados de perto para sequelas de NPHS.


Full text: Available Index: LILACS (Americas) Type of study: Practice guideline Language: English Journal: J. bras. nefrol Journal subject: Nephrology Year: 2022 Type: Article Affiliation country: Turkey Institution/Affiliation country: Gaziantep University/TR

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Full text: Available Index: LILACS (Americas) Type of study: Practice guideline Language: English Journal: J. bras. nefrol Journal subject: Nephrology Year: 2022 Type: Article Affiliation country: Turkey Institution/Affiliation country: Gaziantep University/TR