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Pediatric Nephrology
Published in: Pediatric Nephrology 10/2013

01-10-2013 | Editorial

Pitfalls in recommending evidence-based guidelines for a protean disease like Henoch–Schönlein purpura nephritis

Authors: Jean-Claude Davin, Rosanna Coppo

Published in: Pediatric Nephrology | Issue 10/2013

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Excerpt

The long-term prognosis of Henoch–Schönlein purpura nephritis (HSPN) depends on the severity of initial clinical symptoms and histological features [1, 2]. The risk of evolution into a chronic kidney disease (CKD) may be as high as 50, 40 and 15 % for the combination of onset with nephrotic and nephritic syndrome, nephrotic syndrome, nephritic syndrome and/or heavy non-nephrotic proteinuria, respectively [1]. The International Study of Kidney Disease in Children (ISKDC) classified the risk of progression on the basis of the histology severity mainly according to the extent of crescent formations. Combining three studies with a follow-up of about 6 years [3‐5], Haas [2] demonstrated that 25 % of children biopsied for HSPN had severe outcomes (persistently active renal disease and/or worsened stages of CKD, including end-stage renal failure), in correlation with the ISKDC grades of renal pathology damage. These data indicate that children with HSPN have to be carefully followed, since some cases can have a catastrophic evolution. …
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Metadata
Title
Pitfalls in recommending evidence-based guidelines for a protean disease like Henoch–Schönlein purpura nephritis
Authors
Jean-Claude Davin
Rosanna Coppo
Publication date
01-10-2013
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 10/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-013-2550-4

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