Sun Yuying, Yang Xiaoqing, Xi Leying, Feng Zhiyuan, Ren Xianqing
Department of Pediatrics, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, 450000, China.
Int Urol Nephrol. 2025 May;57(5):1625-1631. doi: 10.1007/s11255-024-04336-7. Epub 2024 Dec 26.
Henoch-Schönlein purpura nephritis (HSPN) has a poor prognosis and variable pathophysiology. The present study aimed to analyze the kidney injury, clinicopathology, and prognosis of HSPN children.
This retrospective study examined 249 children with HSPN. The patients' pathological and clinical data were collected. The patients were divided into the following groups according to the duration of their kidney injury: groups with disease duration of < 2 weeks, 2 weeks to 1 month, 1-2 months, 2-4 months, 4-6 months, and ≥ 6 months. The clinicopathological and prognostic relationships were examined between the groups.
We enrolled 249 children with HSPN (average age of 10.12 ± 3.01 years). There were 161 boys (64.66%) and 88 girls (35.34%). Altogether, 191 children (76.71%) developed kidney injury within 2 months. A total of 37 children (14.86%) showed recurrent renal damage after 6 months. Most patient groups exhibited hematuria and proteinuria, with type III pathology being the most common. During 2 weeks and 1 month of kidney injury, the acute pathology index peaked and then decreased; then, it increased again after 4 months as recurrence occurred. The chronic pathology index was the highest in the group with a disease duration of 2-4 months and it increased with increasing disease duration. The prognosis worsens with the disease duration.
Children with HSPN showed disease remission after a duration of 4-6 months. The acute and chronic pathology indexes peaked between 2 weeks to 1 month and 2-4 months, respectively. Patients with kidney injury occurring within a month had a much higher remission rate.
过敏性紫癜性肾炎（HSPN）预后较差，病理生理过程多变。本研究旨在分析HSPN患儿的肾损伤、临床病理及预后情况。
本回顾性研究纳入了249例HSPN患儿。收集了患者的病理和临床资料。根据肾损伤持续时间将患者分为以下几组：病程<2周、2周1个月、12个月、24个月、46个月及≥6个月组。对各组之间的临床病理及预后关系进行了研究。
我们纳入了249例HSPN患儿（平均年龄10.12±3.01岁）。其中男孩161例（64.66%），女孩88例（35.34%）。共有191例患儿（76.71%）在2个月内出现肾损伤。共有37例患儿（14.86%）在6个月后出现肾损伤复发。大多数患者组表现为血尿和蛋白尿，Ⅲ型病理最为常见。在肾损伤2周和1个月时，急性病理指标达到峰值后下降；然后在4个月后随着复发再次升高。慢性病理指标在病程2~4个月组最高，并随病程延长而升高。预后随病程延长而恶化。
HSPN患儿在病程46个月后病情缓解。急性和慢性病理指标分别在2周1个月和2~4个月达到峰值。1个月内出现肾损伤的患者缓解率要高得多。
