[Outcome of Henoch-Schönlein nephropathy in pediatric patients. Prognostic factors].

OBJECTIVE

To analyze epidemiological, clinical and laboratory data, renal survival curve and short-term (2 years) and long-term (5 years) prognostic factors in children with nephropathy secondary to Henoch-Schönlein purpura (HSP).

MATERIALS AND METHODS

Retrospective analitic cohort study. Clinical records of 100 children diagnosed with HSP at H.I.U. La Fe from 1975-2006 were reviewed. Statistical analysis was by univariate and multivariate analysis.

RESULTS

In 67% of cases, nephropathy coincided with onset of the disease and most commonly manifested hematuria with nonnephrotic proteinuria. 35% of patients were biopsied. The most common histology was mesangial proliferation (46%). Clinical stages at diagnosis were stage B: 63%, stage C: 33%; stage D: 4%. Mean follow-up was 5.25 +/- 0.76 years. Renal data at 5 years: Clinical stages: stage A: 49%, stage B: 27%, stage C: 0%, and stage D: 5%. Renal transplant: 5%. Renal survival curve (Kaplan-Meier) at 5 years: 95%. Prognostic factors: The univariate analysis showed that the prognostic factors of poor renal prognosis in both the short and long-term were age greater than 8 years, number of purpura relapses greater than 4 and presence of stage VI histology. The multivariate analysis showed that only the number of relapses was a short-term prognostic factor.

CONCLUSION

1. The clinical and laboratory data reviewed were similar to those reported in the literature. 2) The renal survival curve at 5 years was 95%. 3) Age, number of relapses and histology were prognostic factors. 4) The multivariate analysis showed that only the number of relapses was a short-term prognostic factor.