ArticlePediatric nephrology (Berlin, Germany)2022
Use of renin-angiotensin system inhibitors as initial therapy in children with Henoch-Schönlein purpura nephritis of moderate severity.
Article in Pediatric nephrology (Berlin, Germany), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Initial treatment with tonsillectomy combined with intravenous methylprednisolone pulse - another option for Japanese children with severe nephrotic IgA vasculitis with nephritis.Pediatric nephrology (Berlin, Germany) · 2024Article
- Tonsillectomy combined with intravenous methylprednisolone pulse for Japanese children with severe IgA vasculitis with nephritis-authors' reply.Pediatric nephrology (Berlin, Germany) · 2024Article
- Long-term outcome of combination therapy with corticosteroids, mizoribine and RAS inhibitors as initial therapy for severe childhood IgA vasculitis with nephritis.Pediatric nephrology (Berlin, Germany) · 2023Article
- Individualized medication based on pharmacogenomics and treatment progress in children with IgAV nephritis.Frontiers in pharmacology · 2022Review
- Development and validation of a nomogram to predict recurrence in children with Henoch-Schönlein purpura.American journal of translational research · 2022Article
Corrections and comments
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Authors and funding
19 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCases of Henoch-Schönlein purpura nephritis (HSPN) with moderate severity were demonstrated to achieve good prognosis after treatment with renin-angiotensin system (RAS) inhibitors. However, some patients required additional treatment for recurrence after remission. This study aimed to clarify the effect of RAS inhibitors in HSPN cases with moderate severity, including the proportion of cases with recurrence and their response to additional treatment.
methodsAmong 126 patients diagnosed with HSPN between 1996 and 2019, 71 patients with clinicopathologically diagnosed HSPN of moderate severity, defined as ISKDC grade II-IIIa and serum albumin ≥ 2.5 g/dL, were investigated.
resultsProteinuria became negative after RAS inhibitor treatment alone in all 71 cases. However, 16 (22.5%) had recurrence. Eleven recurrent cases achieved negative proteinuria again following additional treatment. At the last follow-up (median 46.5 months; IQR, 23.2-98.2), 5 patients had persistent mild proteinuria; no patients had estimated glomerular filtration rate < 90 mL/min/1.73 m
conclusionsJapanese childhood HSPN cases with moderate severity had good outcomes without need for corticosteroids or immunosuppressants, when prescribed RAS inhibitor treatment. Even in recurrent cases, abnormal proteinuria was transient, and prognosis was excellent. A higher resolution version of the Graphical abstract is available as Supplementary information.
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