ArticlePediatric nephrology (Berlin, Germany)2023
Urinary complement proteins are increased in children with IgA vasculitis (Henoch-Schönlein purpura) nephritis.
Article in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Biomarkers in Primary Systemic Vasculitides: Narrative Review.International journal of molecular sciences · 2026Review
- Research progress on biomarkers of immunoglobulin a vasculitis nephritis: from classical molecules to multi-omics system analysis.Frontiers in immunology · 2026Review
- The temporal gene expression landscape of rhabdomyolysis-induced acute kidney injury reveals the timing of complement activation.Communications biology · 2025Article
- IgA Vasculitis (Henoch-Schönlein Purpura): An Update on Treatment.Journal of clinical medicine · 2024Review
- Immunological Features of Children with Gastrointestinal Bleeding Due to Henoch-Schönlein Purpura.Pediatric health, medicine and therapeutics · 2024Article
- Urinary markers of the alternative and lectin complement pathway are increased in IgA vasculitis nephritis.Clinical kidney journal · 2023Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChildren with immunoglobulin A vasculitis (IgAV Henoch-Schönlein purpura) frequently encounter nephritis (IgAV-N) with 1-2% risk of kidney failure. The pathophysiology of IgAV-N is not fully understood with speculation that complement may contribute. The aim of this study was to identify whether urinary complement proteins are increased in children with IgAV-N.
methodsA cross-sectional prospective cohort of children with IgAV were recruited together with controls including healthy children and children with systemic lupus erythematosus (SLE). Patients were subdivided according to the presence of nephritis. Urinary C3, C4, C5, and C5a were measured by enzyme-linked immunosorbent assay (ELISA) and corrected for urinary creatinine.
resultsThe study included 103 children; 47 with IgAV (37 IgAV without nephritis, IgAVwoN; 10 IgAV-N), 30 SLE and 26 healthy children. Urinary complement C3, C4, and C5 were all statistically significantly increased in all children with IgAV compared to SLE patients (all p < 0.05). In patients with IgAV-N, urinary complement C3, C4, C5, C5a were all statistically significantly increased compared to IgAVwoN (C3 14.65 μg/mmol [2.26-20.21] vs. 2.26 μg/mmol [0.15-3.14], p = 0.007; C4 6.52 μg/mmol [1.30-9.72] vs. 1.37 μg/mmol [0.38-2.43], p = 0.04; C5 1.36 μg/mmol [0.65-2.85] vs. 0.38 μg/mmol [0.03-0.72], p = 0.005; C5a 101.9 ng/mmol [15.36-230.0] vs. 18.33 ng/mmol [4.27-33.30], p = 0.01). Using logistic regression, the urinary complement components produced an outstanding ability to discriminate between patients with and without nephritis in IgAV (AUC 0.92, p < 0.001).
conclusionsChildren with IgAV-N have evidence of increased complement proteins present in their urine that may indicate a pathological role and may allow treatment stratification. A higher resolution version of the Graphical abstract is available as Supplementary information.
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