The Analysis of Renal Risk Factors in Henoch-Schonlein Purpura

Koo, Hyun Hoe; Ha, Tae Sun

Abstract

PURPOSE
Henoch-Schonlein purpura (HSP) is a multisystem disorder affecting predominantly skin, gastrointestinal tract, joint and kidneys, as well as the central nervous, cardiopulmonary and musculoskeletal system. Most patients with renal involvement have a good prognosis. However, some patients develop end-stage renal disease. Therefore, severity of renal involvement is considered to contribute to the outcome. The aim of this study was to evaluate the clinical renal risk and prognostic factors of HSP. METHODS: We had collected the clinical and laboratory data of 125 patients with acute HSP who visited Chungbuk National University Hospital from March 1992 to April 2002. Data were expressed as the mean+/-SD and statistical analysis was performed using Wilcoxon rank sum test, Mantel-Haenszel test, Fisher's Exact test, Student t-test. p<0.05 was considered as significant. RESULTS: The patient population consisted of 87 boys and 38 girls ranging from 1 to 14 years in age. Recurrance number of purpura in the HSP patients with renal involvement were significantly higher than those without renal involvement (p<0.01). 24-hour urine protein/creatinine ratio in the HSP patients with renal involvement were significantly higher than those without renal involvement (p< 0.01). But serum C3, C4, CH50, anti-streptolysin titers and so forth had no correlation with renal involvement. In the HSN patients, 24-hour creatinine and creatinine clearance have no correlation with renal involvement. Fifteen of 87 boys (17.2%) in this study developed scrotal involvement, which showed no significantly difference in patients with or without renal involvement. CONCLUSION: It is important that 24-hour urine protein/creatinine ratio at acute stage shows a significant relation with renal involvement. Results suggest that recurrence number of purpura are important to renal involvement in HSP. Based on these findings, futher prospective and/or controlled studies among more patients are thus necessary in order to prevent renal involvement in HSP.