Zaffanello Marco, Fanos Vassilios
Department of Mother-Child and Biology-Genetics, University of Verona, 37134 Verona, Italy.
Pediatr Nephrol. 2009 Oct;24(10):1901-11. doi: 10.1007/s00467-008-1066-9. Epub 2008 Dec 9.
Considerable concern has been expressed on the importance of identifying an improved therapeutic protocol for use in the treatment of childhood Henoch-Schönlein purpura nephritis, primarily due to the unpredictable success shown to date in improving long-term renal outcome. This review focuses on published reports describing the outcomes of therapeutic approaches currently being used in the treatment of pediatric Henoch-Schönlein purpura nephritis, with the aim of providing information that will facilitate a treatment-based approach in children presenting with varying degrees of kidney disease. The conclusions of the authors of this review are that currently prescribed treatments of children affected by Henoch-Schönlein purpura nephritis are not adequately guided by evidence obtained in properly designed, randomized, placebo-controlled trials with outcome markers related to the progression to end stage renal disease (level I evidence). Moreover, firm evidence supporting the best practice to be applied with the aim of delaying the progression of kidney disease is still lacking.
对于确定一种改进的治疗方案用于治疗儿童过敏性紫癜性肾炎的重要性，人们已表达了相当多的关注，这主要是由于迄今为止在改善长期肾脏预后方面所显示出的不可预测的成功率。本综述聚焦于已发表的报告，这些报告描述了目前用于治疗小儿过敏性紫癜性肾炎的治疗方法的结果，目的是提供信息，以便为患有不同程度肾脏疾病的儿童采取基于治疗的方法提供便利。本综述的作者得出的结论是，目前针对受过敏性紫癜性肾炎影响儿童所规定的治疗方法，并未得到在设计合理、随机、安慰剂对照试验中获得的证据的充分指导，这些试验的结果标志物与终末期肾病的进展相关（一级证据）。此外，仍然缺乏支持为延缓肾脏疾病进展而应用的最佳实践的确凿证据。
