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To biopsy or not to biopsy: Henoch-Schönlein nephritis in children, a 5-year follow-up study
- Source :
- Pediatric Nephrology. 37:147-152
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- The prognosis of Henoch-Schonlein purpura (HSP), IgA vasculitis, depends on kidney involvement. There is no consensus on the initiation of treatment for HSP nephritis (HSPN). Some centres start treatment before performing a kidney biopsy (KB) while in others, treatment is dictated by the importance of the clinical, biological and histological signs. The aim of this study was to evaluate which of these two approaches is associated with a better kidney outcome at 5-year follow-up. This multicentre, retrospective, nonrandomised study included children treated for HSPN between 2006 and 2010 in a French paediatric nephrology unit. One group had an early KB at diagnosis (before starting treatment or in the 15 following days). In the second group, initial treatment was decided without performing a KB. Among the 107 children included, 63.5% had an early KB at diagnosis. Follow-up at 5 years was completed in 44 children (28 KB at diagnosis, 16 no KB at diagnosis). Median urine protein/creatinine at 5 years was 2.5 mg/mmol in the early biopsy diagnosis group and 12.5 mg/mmol in the non-biopsy group. An antiproteinuric treatment was given, at 5 years, to 35.7% of the early biopsy at diagnosis children and in 62.5% of the non-biopsied children. Children with early KB at diagnosis seem to have a better renal outcome at 5 years compared to those without an early biopsy at diagnosis or biopsied later. However, this is a small patient cohort and data are missing. Further work is needed to build consensual guidelines on the management of HSPN in children.
- Subjects :
- Nephrology
medicine.medical_specialty
Nephritis
Proteinuria
Henoch-Schonlein purpura
medicine.diagnostic_test
business.industry
Biopsy
medicine.disease
Nephropathy
IgA vasculitis
Internal medicine
Pediatrics, Perinatology and Child Health
Cohort
medicine
Humans
medicine.symptom
Child
business
Follow-Up Studies
Retrospective Studies
Subjects
Details
- ISSN :
- 1432198X and 0931041X
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Pediatric Nephrology
- Accession number :
- edsair.doi.dedup.....4042acec4cf61468ff347c3d869c6344