Risk factors associated with IgA vasculitis with nephritis (Henoch–Schönlein purpura nephritis) progressing to unfavorable outcomes: A meta-analysis
Autoři:
Dongmei Shi aff001; Han Chan aff001; Xia Yang aff003; Gaofu Zhang aff001; Haiping Yang aff001; Mo Wang aff001; Qiu Li aff001
Působiště autorů:
Department of Nephrology, Children’s Hospital, Chongqing Medical University, Chongqing, China
aff001; Children’s Hospital of Chongqing Medical University, Yuzhong District, Chongqing, People’s Republic of China
aff002; Ministry of Education, Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Children’s Hospital of Chongqing Me
aff003
Vyšlo v časopise:
PLoS ONE 14(10)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0223218
Souhrn
Objective
To identify risk factors associated with unfavorable outcomes in children with IgA vasculitis with nephritis (Henoch-Schőnlein purpura nephritis)(IgA-VN)
Methods
PubMed, Embase, and Web of Science databases were searched for studies, published in English through February 2019. The data were extracted to perform pooled analysis, heterogeneity testing, subgroup analysis, sensitivity analysis, and publication bias analysis.
Results
This meta-analysis showed that, older age at onset (WMD 1.77, 95% CI 0.35–3.18, p = 0.014), lower glomerular filtration rate (GFR; WMD -23.93, 95% CI -33.78- -14.09, p<0.0001), initial renal manifestations with nephrotic syndrome (OR 1.74, 95% CI 1.12–2.70, p = 0.013), with nephritic-nephrotic syndrome (OR 4.55, 95% CI 2.89–7.15, p<0.0001) and renal biopsy with crescentic nephritis (International Study of Kidney Disease in Children [ISKDC] grades III-V) (OR 3.85, 95% CI 2.37–6.28, p<0.0001) were significant risk factors associated with poor outcomes in IgA-VN, whereas initial clinical features with hematuria (OR 0.33, 95% CI 0.16–0.69, p = 0.003) and mild proteinuria±hematuria (OR 0.46, 95% CI 0.28–0.75, p<0.0001) were associated with progression to good outcomes. By contrast, gender, hypertension and initial renal manifestations of acute nephritic syndrome were not significantly associated with poor outcomes in IgA-VN.
Conclusion
This meta-analysis showed that older age at onset, lower GFR, initial renal features of nephrotic syndrome and nephritic-nephrotic syndrome and renal biopsy with crescentic nephritis (ISKDC grades III-V) were predictive of poor prognosis in children with IgA-VN.
Klíčová slova:
Medical risk factors – Proteinuria – Glomerular filtration rate – Prognosis – Biopsy – Nephritis – Renal analysis
Zdroje
1. Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet.2002; 360(9341):1197–1202. doi: 10.1016/S0140-6736(02)11279-7 12401245
2. Rai A, Nast C, Adler S. Henoch-Schönlein purpura nephritis. J Am Soc Nephrol.1999; 10:2637–2644. 10589705
3. Koskimies O, Mir S, Rapola J, Vilska J. Henoch-Schönlein nephritis: long-term prognosis of unselected patients. Arch Dis Child.1981;56:482–484. doi: 10.1136/adc.56.6.482 7259283
4. Stewart M, Savage JM, Bell B, McCord B.Long-term renal prognosis of HenochSchönlein purpura in an unselected childhood population. Eur J Pediatr.1988; 147:113–115. doi: 10.1007/bf00442205 3366130
5. Coppo R, Mazzucco G, Cagnoli L, Lupo A, Schena FP. Long-term prognosis of HenochSchönlein nephritis in adults and children. Italian Group of Renal Immunopathology Collaborative Study on Henoch-Schonlein purpura. Nephrol Dial Transplant.1997; 12:2277–2283. doi: 10.1093/ndt/12.11.2277 9394311
6. Soylemezoglu O, Ozkaya O, Ozen S, Bakkaloglu A, Dusunsel R, Peru H, et al. Henoch-Schönlein nephritis: a nationwide study. Nephron Clin Pract.2009; 112(3):c199–204. doi: 10.1159/000218109 19439991
7. Delbet JD, Hogan J, Aoun B, Stoica I, Salomon R, Decramer S, et al. Clinical outcomes in children with Henoch-Schönlein purpura nephritis without crescents. Pediatr Nephrol.2017; 32(7):1193–1199. doi: 10.1007/s00467-017-3604-9 28204946
8. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration website. http://training.cochrane.org/handbook. 2011. Accessed February 26, 2018.
9. Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J Clin Epidemiol.2009; 62(10):1006–1012. doi: 10.1016/j.jclinepi.2009.06.005 19631508
10. Meadow SR, Glasgow EF, White RH. Schönlein-Henoch nephritis. Q J Med.1972; 41:241–258.11. 4538491
11. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics.2004; 114:555–576. 15286277
12. Counahan R, Winterborn MH, White RH, Heaton JM, Meadow SR, Bluett NH, et al. Prognosis of Henoch-Schönlein nephritis in children. Br Med J.1977; 2(6078):11–4. doi: 10.1136/bmj.2.6078.11 871734
13. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al; STROBE Initiative. Strengthening the reporting of observational studies in epidemiology(STROBE):explanation andelaboration. Int J Surg.2014; 12(12):1500–24.14. doi: 10.1016/j.ijsu.2014.07.014 25046751
14. Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the assessment of the quality of nonrandomized studies in meta-ananlyses. Eur J Epidemiol.2010; 25(9):603–605. doi: 10.1007/s10654-010-9491-z 20652370
15. Tobias A. Assessing the influence of a single study in meta-analysis.Stata Tech Bull.1999; 47:15–17.
16. Stata Corp. 2011.Stata Statistical Software: Release 14. College Station, TX: StataCorp LP: Available from: http://www.stata.com/support/faqs/resources/citing-software-documentation-faqs/.
17. Koskela M, Ylinen E, Ukonmaanaho EM, Autio-Harmainen H, Heikkilä P, Lohi J, et al. The ISKDC classification and a new semiquantitative classification for predicting outcomes of Henoch-Schönlein purpura nephritis. Pediatr Nephro.2017; 32(7):1201–1209. doi: 10.1007/s00467-017-3608-5 28197887
18. Edström-Halling S, Söderberg MP, Berg UB. Predictors of outcome in Henoch-Schönlein nephritis. Pediatr Nephrol.2010; 25(6):1101–8. doi: 10.1007/s00467-010-1444-y 20174831
19. Mir S, Yavascan O, Mutlubas F, Yeniay B, Sonmez F. Clinical outcome in children with Henoch-Schönlein nephritis. Pediatr Nephrol.2007; 22:64–70. doi: 10.1007/s00467-006-0278-0 17024391
20. Kawasaki Y, Suzuki J, Sakai N, Nemoto K, Nozawa R, Suzuki S, et al. Clinical and pathological features of children with Henoch-Schönlein nephritis:risk factors associated with poor prognosis. Clin Nephrol.2003; 60(3):153–60. doi: 10.5414/cnp60153 14524577
21. Schärer K, Krmar R, Querfeld U, Ruder H, Waldherr R, Schaefer F. Clinical outcome of Schönlein-Henoch purpura nephritis in children. Pediatr Nephrol.1999; 13(9):816–23. doi: 10.1007/s004670050707 10603128
22. Goldstein AR, White RH, Akuse R, Chantler C. Long-term follow-up of childhood Henoch-Schönlein nephritis. Lancet. 1992;339(8788):280–2. doi: 10.1016/0140-6736(92)91341-5 1346291
23. Koskimies O, Mir S, Rapola J, Vilska J. Henoch-Schönlein nephritis: long-term prognosis of unselected patients. Arch Dis Child.1981; 56(6):482–4. doi: 10.1136/adc.56.6.482 7259283
24. Wozniak A, Pluta-Hadas K, Zurawski J, Janicka-Jedynska M, Kaczmarek E, Zachwieja J, et al. Electron-microscopic and immunohistochemical study in Henoch-Schoenlein nephritis. Ultrastruct Pathol.2013; 37(1):83–92. doi: 10.3109/01913123.2012.670035 23383618
25. Wakaki H, Ishikura K, Hataya H, Hamasaki Y, Sakai T, Yata N, et al. Henoch-Schönlein purpura nephritis with nephrotic state in children: predictors of poor outcomes. Pediatr Nephrol.2011; 26:921–925. doi: 10.1007/s00467-011-1827-8 21373776
26. Lucas-García J, Alvarez-Blanco O, Sanahuja-Ibáñez MJ, Ortega-López PJ, Zamora-Martín I. Outcome of Henoch-Schönlein nephropathy in pediatric patients. Prognostic factors. Nefrologia.2008; 28(6):627–32. 19016636
27. Chan H, Tang YL, Lv XH, Zhang GF, Wang M, Yang HP, et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schonlein Purpura: A Meta-Analysis. PLoS One.2016; 11(11):e0167346. doi: 10.1371/journal.pone.0167346 27902749
28. Xu K, Zhang L, Ding J, Wang S, Su B, Xiao H, et al. Value of the Oxford classification of IgA nephropathy in children with Henoch-Schönlein purpura nephritis. J Nephrol.2018; 31(2):279–286. doi: 10.1007/s40620-017-0457-z 29185209
29. Feng D, Huang WY, Hao S, Niu XL, Wang P, Wu Y, et al. A single-center analysis of Henoch-Schonlein purpura nephritis with nephrotic proteinuria in children. Pediatr Rheumatol Online J.2017; 15(1):15. doi: 10.1186/s12969-017-0146-4 28257644
30. Bogdanović R. Henoch-Schönlein purpura nephritis in children: risk factors, prevention and treatment. Acta Paediatr.2009; 98(12):1882–9. doi: 10.1111/j.1651-2227.2009.01445.x 19650836
31. Tarshish P, Bernstein J, Edelmann CM Jr. Henoch-Schnlein purpura nephritis:course of disease and efficacy of cyclophosphamide. Pediatr Nephrol.2004; 19:51–56. doi: 10.1007/s00467-003-1315-x 14634864
32. Narchi H. Risk of long term renal impairment and duration of follow up recommended for Henoch-SchonleinSchönlein purpura with normal or minimal urinary findings: a systematic review. Arch Dis Child.2005; 90:916–920. doi: 10.1136/adc.2005.074641 15871983.
33. Ronkainen J, Nuutinen M, Koskimies O. The adult kidney 24 years after childhood purpura: a retrospective cohort study. Lancet.2002; 360:666–670. doi: 10.1016/S0140-6736(02)09835-5 12241872
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